Caceres’ Corner Case 125 (Update: Solution)

ESR_2015_Blog-CaceresCorner-125

Dear Friends,

You may wonder what a foot is doing in a chest blog. The answer is obvious: because the foot belongs to a chest radiologist. These radiographs are of my own foot, where I noticed a painless swelling in the 4th right toe, present for about one year. Check the images below, leave me your thoughts and diagnosis in the comments, and come back on Friday for the answer.

Diagnosis:
1. Type 1 chondrosarcoma
2. Pigmented villonodular synovitis
3. Synovioma
4. None of the above


AP view

oblique view

Click here for the answer to case #125

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    Nov 2015
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    DISCUSSION 17 Comments

    17 Responses to : Caceres’ Corner Case 125 (Update: Solution)

    1. genchi bari italia says:

      ….carissimo professore, quale onore averti come “paziente “….non può essere una sinovite villo-nodulare, perche’ essa interessa due superfici articolari contrapposte e colpisce sopratutto le grandi articolazioni( anca-ginocchio…), non può essere sinovioma perchè in quel punto non c’è sinovia…..non mi sembra un processo maligno come da condrosarcomsa…..sembrerebbe invece un encondroma……Complimenti al Barca….ha spezzettato in 4 il Real….anche il mio Bari vola…..

    2. Aloria says:

      Intrasseous gout

    3. Aloria says:

      And I am very sorry to see that, Professor!

    4. sht says:

      None of the above – gout

    5. magda says:

      maybe 2?

    6. MediArt.co says:

      Solo Descripcion.
      Lesión lítica, agresiva, transarticular, requiere mas estudios de imagen. Entre las posibilidades encomdroma? Sarcoma Sinovial? Artritis? RM correlación con la clínica.

    7. Jose Caceres says:

      Maybe

    8. genchi bari italia says:

      ….poche risposte……come il grande Barca, mitico professore hai messo paura a tutti …..chi ti “sfida” rischia la fine del Real o della Roma !!!!!!

    9. J says:

      Lytic lesion affecting the middle and distal phalanx of the fourth finger with cortical destruction and regional increase in soft tissues. The slow growth and the absence of pain for a long time suggest a benign or a low grade of malignancy lession. We have to take into account: radiographic features, age, the clinical presentation and the personal history. My first choice would be a giant cell tumor but the differential diagnosis is wide: synovial sarcoma, enchondroma, chondrosarcoma, etc. It is necessary to extend study by MRI and biopsy.
      Good people deserve the best for what I want it to be a benign lesion, we need the professor in shape.

    10. Yvette says:

      Chondrosarcoma of low grade, chondromyxoid fibroma or enchondroma.
      Lytic lesion, no periosteal reaction, sharp transition zone sugest benign character. Archs and rings shape and calcifications sugest chondro origin. MR in further diagnostic.

    11. genchi bari italia says:

      …una visione più attenta delle immagini fa notare una tumefazione concomitante delle parti molli…..nell’encondroma , questa tumefazione non è presente….dovremo allora pensare ad una lesione primitiva delle parti molli con secondaria azione litica sulla falange….sulla superficie dorsale della falange decorrono i tendini estensori con le le loro guaine….pertanto una lesione tendinea….sinovialoma….

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