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Osteochondroma
A. Carlson Merrow, Jr., MD, FAAP
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Definitions

              • Osteochondroma (OC): Benign, developmental bony surface lesion arising from displaced growth cartilage
                • Not true neoplasm
                • Generally synonymous with exostosis
              • Maintains corticomedullary continuity with underlying bone
              • Covered by hyaline cartilage cap

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Ultrasonographic Findings

                      • Nuclear Medicine Findings

                        • Angiographic Findings

                          • Imaging Recommendations

                            DIFFERENTIAL DIAGNOSIS

                              PATHOLOGY

                              • General Features

                                • Gross Pathologic & Surgical Features

                                  • Microscopic Features

                                    CLINICAL ISSUES

                                    • Presentation

                                      • Demographics

                                        • Natural History & Prognosis

                                          • Treatment

                                            DIAGNOSTIC CHECKLIST

                                            • Image Interpretation Pearls

                                              • Reporting Tips

                                                Selected References

                                                1. Iqbal A et al: Osteochondroma-induced pseudoaneurysms of the extremities mimicking sarcoma: a report of seven contemporary and one historical case. Clin Radiol. 75(8):642.e9-13, 2020
                                                2. Jurik AG et al: Whole-body MRI in assessing malignant transformation in multiple hereditary exostoses and enchondromatosis: audit results and literature review. Skeletal Radiol. 49(1):115-24, 2020
                                                3. Martínez Álvarez S et al: Bizarre parosteal osteochondromatous proliferation (Nora lesion) in pediatric phalanges. J Hand Surg Am. 46(4):344.e1-9, 2020
                                                4. Milton CK et al: Solitary osteochondroma of the cervical spine presenting with quadriparesis and hand contracture. Surg Neurol Int. 11:51, 2020
                                                5. Jackson TJ et al: Is Routine spine MRI necessary in skeletally immature patients with MHE? Identifying patients at risk for spinal osteochondromas. J Pediatr Orthop. 39(2):e147-52, 2019
                                                6. Purandare NC et al: Can 18F-FDG PET/CT diagnose malignant change in benign chondroid tumors? Nucl Med Commun. 40(6):645-51, 2019
                                                7. Tsuda Y et al: Secondary chondrosarcoma arising from osteochondroma: outcomes and prognostic factors. Bone Joint J. 101-B(10):1313-20, 2019
                                                8. Aiba H et al: Spontaneous shrinkage of solitary osteochondromas. Skeletal Radiol. 47(1):61-8, 2018
                                                9. Degnan AJ et al: More than epiphyseal osteochondromas: updated understanding of imaging findings in dysplasia epiphysealis hemimelica (Trevor Disease). AJR Am J Roentgenol. 211(4):910-9, 2018
                                                10. Duque Orozco MDP et al: Magnetic resonance imaging in symptomatic children with hereditary multiple exostoses of the hip. J Pediatr Orthop. 38(2):116-21, 2018
                                                11. Zanotti MC et al: A multidisciplinary approach for the treatment of young patients with suprasellar osteochondroma. Childs Nerv Syst. 34(3):559-63, 2018
                                                12. Kim HK et al: T2 relaxation time mapping of the cartilage cap of osteochondromas. Korean J Radiol. 17(1):159-65, 2016
                                                13. Wodajo FM: Top five lesions that do not need referral to orthopedic oncology. Orthop Clin North Am. 46(2):303-14, 2015
                                                14. Sonne-Holm E et al: Multiple cartilaginous exostoses and development of chondrosarcomas--a systematic review. Dan Med J. 61(9):A4895, 2014
                                                15. Rangdal SS et al: Pseudoaneurysm of the popliteal artery in a child with multiple hereditary exostosis: a rare case report and literature review. J Pediatr Orthop B. 22(4):353-6, 2013
                                                16. Satija B et al: Dysplasia epiphysealis hemimelica of talus mimicking posterior ankle impingement syndrome in a young male: a case report with review of the literature. J Foot Ankle Surg. 52(4):518-22, 2013
                                                17. Douis H et al: The imaging of cartilaginous bone tumours. I. Benign lesions. Skeletal Radiol. 41(10):1195-212, 2012
                                                18. Passanise AM et al: Radiographic evidence of regression of a solitary osteochondroma: a report of 4 cases and a literature review. J Pediatr Orthop. 31(3):312-6, 2011
                                                19. Bernard SA et al: Improved differentiation of benign osteochondromas from secondary chondrosarcomas with standardized measurement of cartilage cap at CT and MR imaging. Radiology. 255(3):857-65, 2010
                                                20. Lotfinia I et al: Neurological manifestations, imaging characteristics, and surgical outcome of intraspinal osteochondroma. J Neurosurg Spine. 12(5):474-89, 2010
                                                21. Marcovici PA et al: Osteochondromas and growth retardation secondary to externally or internally administered radiation in childhood. Pediatr Radiol. 37(3):301-4, 2007
                                                22. Jin W et al: Costal osteochondroma presenting as haemothorax and diaphragmatic laceration. Pediatr Radiol. 35(7):706-9, 2005
                                                23. Geirnaerdt MJ et al: Cartilaginous tumors: fast contrast-enhanced MR imaging. Radiology. 214(2):539-46, 2000
                                                24. Murphey MD et al: Imaging of osteochondroma: variants and complications with radiologic-pathologic correlation. Radiographics. 20(5):1407-34, 2000
                                                25. Robbin MR et al: Benign chondroid neoplasms of bone. Semin Musculoskelet Radiol. 4(1):45-58, 2000
                                                26. Brien EW et al: Benign and malignant cartilage tumors of bone and joint: their anatomic and theoretical basis with an emphasis on radiology, pathology and clinical biology. II. Juxtacortical cartilage tumors. Skeletal Radiol. 28(1):1-20, 1999
                                                Related Anatomy
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                                                Related Differential Diagnoses
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                                                References
                                                Tables

                                                Tables

                                                KEY FACTS

                                                • Terminology

                                                  • Imaging

                                                    • Top Differential Diagnoses

                                                      • Pathology

                                                        • Clinical Issues

                                                          TERMINOLOGY

                                                          • Definitions

                                                            • Osteochondroma (OC): Benign, developmental bony surface lesion arising from displaced growth cartilage
                                                              • Not true neoplasm
                                                              • Generally synonymous with exostosis
                                                            • Maintains corticomedullary continuity with underlying bone
                                                            • Covered by hyaline cartilage cap

                                                          IMAGING

                                                          • General Features

                                                            • Radiographic Findings

                                                              • CT Findings

                                                                • MR Findings

                                                                  • Ultrasonographic Findings

                                                                    • Nuclear Medicine Findings

                                                                      • Angiographic Findings

                                                                        • Imaging Recommendations

                                                                          DIFFERENTIAL DIAGNOSIS

                                                                            PATHOLOGY

                                                                            • General Features

                                                                              • Gross Pathologic & Surgical Features

                                                                                • Microscopic Features

                                                                                  CLINICAL ISSUES

                                                                                  • Presentation

                                                                                    • Demographics

                                                                                      • Natural History & Prognosis

                                                                                        • Treatment

                                                                                          DIAGNOSTIC CHECKLIST

                                                                                          • Image Interpretation Pearls

                                                                                            • Reporting Tips

                                                                                              Selected References

                                                                                              1. Iqbal A et al: Osteochondroma-induced pseudoaneurysms of the extremities mimicking sarcoma: a report of seven contemporary and one historical case. Clin Radiol. 75(8):642.e9-13, 2020
                                                                                              2. Jurik AG et al: Whole-body MRI in assessing malignant transformation in multiple hereditary exostoses and enchondromatosis: audit results and literature review. Skeletal Radiol. 49(1):115-24, 2020
                                                                                              3. Martínez Álvarez S et al: Bizarre parosteal osteochondromatous proliferation (Nora lesion) in pediatric phalanges. J Hand Surg Am. 46(4):344.e1-9, 2020
                                                                                              4. Milton CK et al: Solitary osteochondroma of the cervical spine presenting with quadriparesis and hand contracture. Surg Neurol Int. 11:51, 2020
                                                                                              5. Jackson TJ et al: Is Routine spine MRI necessary in skeletally immature patients with MHE? Identifying patients at risk for spinal osteochondromas. J Pediatr Orthop. 39(2):e147-52, 2019
                                                                                              6. Purandare NC et al: Can 18F-FDG PET/CT diagnose malignant change in benign chondroid tumors? Nucl Med Commun. 40(6):645-51, 2019
                                                                                              7. Tsuda Y et al: Secondary chondrosarcoma arising from osteochondroma: outcomes and prognostic factors. Bone Joint J. 101-B(10):1313-20, 2019
                                                                                              8. Aiba H et al: Spontaneous shrinkage of solitary osteochondromas. Skeletal Radiol. 47(1):61-8, 2018
                                                                                              9. Degnan AJ et al: More than epiphyseal osteochondromas: updated understanding of imaging findings in dysplasia epiphysealis hemimelica (Trevor Disease). AJR Am J Roentgenol. 211(4):910-9, 2018
                                                                                              10. Duque Orozco MDP et al: Magnetic resonance imaging in symptomatic children with hereditary multiple exostoses of the hip. J Pediatr Orthop. 38(2):116-21, 2018
                                                                                              11. Zanotti MC et al: A multidisciplinary approach for the treatment of young patients with suprasellar osteochondroma. Childs Nerv Syst. 34(3):559-63, 2018
                                                                                              12. Kim HK et al: T2 relaxation time mapping of the cartilage cap of osteochondromas. Korean J Radiol. 17(1):159-65, 2016
                                                                                              13. Wodajo FM: Top five lesions that do not need referral to orthopedic oncology. Orthop Clin North Am. 46(2):303-14, 2015
                                                                                              14. Sonne-Holm E et al: Multiple cartilaginous exostoses and development of chondrosarcomas--a systematic review. Dan Med J. 61(9):A4895, 2014
                                                                                              15. Rangdal SS et al: Pseudoaneurysm of the popliteal artery in a child with multiple hereditary exostosis: a rare case report and literature review. J Pediatr Orthop B. 22(4):353-6, 2013
                                                                                              16. Satija B et al: Dysplasia epiphysealis hemimelica of talus mimicking posterior ankle impingement syndrome in a young male: a case report with review of the literature. J Foot Ankle Surg. 52(4):518-22, 2013
                                                                                              17. Douis H et al: The imaging of cartilaginous bone tumours. I. Benign lesions. Skeletal Radiol. 41(10):1195-212, 2012
                                                                                              18. Passanise AM et al: Radiographic evidence of regression of a solitary osteochondroma: a report of 4 cases and a literature review. J Pediatr Orthop. 31(3):312-6, 2011
                                                                                              19. Bernard SA et al: Improved differentiation of benign osteochondromas from secondary chondrosarcomas with standardized measurement of cartilage cap at CT and MR imaging. Radiology. 255(3):857-65, 2010
                                                                                              20. Lotfinia I et al: Neurological manifestations, imaging characteristics, and surgical outcome of intraspinal osteochondroma. J Neurosurg Spine. 12(5):474-89, 2010
                                                                                              21. Marcovici PA et al: Osteochondromas and growth retardation secondary to externally or internally administered radiation in childhood. Pediatr Radiol. 37(3):301-4, 2007
                                                                                              22. Jin W et al: Costal osteochondroma presenting as haemothorax and diaphragmatic laceration. Pediatr Radiol. 35(7):706-9, 2005
                                                                                              23. Geirnaerdt MJ et al: Cartilaginous tumors: fast contrast-enhanced MR imaging. Radiology. 214(2):539-46, 2000
                                                                                              24. Murphey MD et al: Imaging of osteochondroma: variants and complications with radiologic-pathologic correlation. Radiographics. 20(5):1407-34, 2000
                                                                                              25. Robbin MR et al: Benign chondroid neoplasms of bone. Semin Musculoskelet Radiol. 4(1):45-58, 2000
                                                                                              26. Brien EW et al: Benign and malignant cartilage tumors of bone and joint: their anatomic and theoretical basis with an emphasis on radiology, pathology and clinical biology. II. Juxtacortical cartilage tumors. Skeletal Radiol. 28(1):1-20, 1999