Arterial and venous compromise by an osteochondroma

Shore, Richard M.; Poznanski, Andrew K.; Anandappa, Eugene; Dias, Luciano

doi:10.1007/bf02017658

Cited by 17 publications

(19 citation statements)

References 9 publications

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“…Pseudoaneurysm (Fig. 8), arterial thrombosis, thromboembolism, arterial compression with claudication, and transsection have been reported [6,14,15,16]. Venous complications are less frequent sequelae, which include chronic venous compression and thrombosis [14].…”

Section: Vascular Complicationsmentioning

confidence: 97%

“…Arterial injury most commonly involves the popliteal and distal femoral region, where the arteries are relatively fixed in position. Furthermore, the distal femur and proximal tibia and fibula represent common locations for large osteochondromas to occur [14,15,16]. Pseudoaneurysm (Fig.…”

Section: Vascular Complicationsmentioning

confidence: 98%

“…Most vascular complications occur at skeletal maturity, as ossification of the cartilaginous cap increases the risk of injury to adjacent vessels [15]. Angiography or Doppler ultrasound are usually required to demonstrate arterial and/or venous complications [14,17]. On contrast-enhanced CT the thrombosed lumen of a popliteal artery pseudoaneurysm can be misdiagnosed as malignant transformation of the osteochondroma [18].…”

Section: Vascular Complicationsmentioning

confidence: 98%

“…Magnetic resonance imaging has been shown to provide excellent demonstration of both, arterial and venous compromise. Due to their angiographic effect, gradient-echo sequences proved to be useful in depiction of the anatomic relation between the osteochondroma and compressed vessels [14]. Arterial pseudoaneurysms usually demonstrate inhomogeneous signal intensity caused by blood-breakdown products of different age within thrombosed material and turbulent flow [6], typically resulting in an onion-skin-like, laminated appearance (Fig.…”

Section: Vascular Complicationsmentioning

confidence: 98%

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Osteochondroma: MR imaging of tumor-related complications

et al. 2000

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Osteochondromas can be complicated by mechanical irritation, compression or injury of adjacent structures, fracture, malignant transformation, and postoperative recurrence. Magnetic resonance imaging represents the most valuable imaging modality in symptomatic cases, because it can demonstrate typical features of associated soft tissue pathology, which can be differentiated from malignant transformation. Reactive bursae formation presents as an overlying fluid collection with peripheral contrast enhancement. Dislocation, deformation, and signal alterations of adjacent soft tissue structures can be observed in different impingement syndromes caused by osteochondromas. Magnetic resonance imaging provides excellent demonstration of arterial and venous compromise and represents the method of choice in cases with compression of spinal cord, nerve roots, or peripheral nerves, depicting changes in size, position, and signal intensity of the affected neural structures. Malignant transformation as the most worrisome complication occurs in approximately 1% of solitary and 5-25% of multiple osteochondromas. Magnetic resonance imaging is the most accurate method in measuring cartilage cap thickness, which represents an important criterion for differentiation of osteochondromas and exostotic (low-grade) chondrosarcomas. Cartilage cap thickness exceeding 2 cm in adults and 3 cm in children should raise the suspicion for malignant transformation. Finally, MR imaging can detect postoperative recurrence by depiction of a recurrent mass presenting typical morphological features of a cartilage-forming lesion.

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Section: Vascular Complicationsmentioning

confidence: 97%

Section: Vascular Complicationsmentioning

confidence: 98%

Section: Vascular Complicationsmentioning

confidence: 98%

Section: Vascular Complicationsmentioning

confidence: 98%

See 2 more Smart Citations

Osteochondroma: MR imaging of tumor-related complications

et al. 2000

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“…Vascular complications associated with osteochondroma include vessel displacement, stenosis, occlusion, and pseudoaneurysm formation (63)(64)(65)(66)(67)(68)(69)(70)(71)(72)(73)(74)(75)(76). Displacement of adjacent vessels by these lesions is common, particularly when they are large, but it is typically asymptomatic.…”

Section: Vascular Compromisementioning

confidence: 99%

Imaging of Osteochondroma: Variants and Complications with Radiologic-Pathologic Correlation

Murphey¹,

Choi²,

Kransdorf³

et al. 2000

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Osteochondroma represents the most common bone tumor and is a developmental lesion rather than a true neoplasm. It constitutes 20%-50% of all benign bone tumors and 10%-15% of all bone tumors. Its radiologic features are often pathognomonic and identically reflect its pathologic appearance. Osteochondromas are composed of cortical and medullary bone with an overlying hyaline cartilage cap and must demonstrate continuity with the underlying parent bone cortex and medullary canal. Osteochondromas may be solitary or multiple, the latter being associated with the autosomal dominant syndrome, hereditary multiple exostoses (HME). Complications associated with osteochondromas are more frequent with HME and include deformity (cosmetic and osseous), fracture, vascular compromise, neurologic sequelae, overlying bursa formation, and malignant transformation. Malignant transformation is seen in 1% of solitary osteochondromas and in 3%-5% of patients with HME. Continued lesion growth and a hyaline cartilage cap greater than 1.5 cm in thickness, after skeletal maturity, suggest malignant transformation. Variants of osteochondroma include subungual exostosis, dysplasia epiphysealis hemimelica, turret and traction exostoses, bizarre parosteal osteochondromatous proliferation, and florid reactive periostitis. Recognition of the radiologic spectrum of appearances of osteochondroma and its variants usually allows prospective diagnosis and differentiation of the numerous potential complications, thus helping guide therapy and improving patient management.

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Benign Conditions

Connolly

Treves

1998

Pediatric Skeletal Scintigraphy

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Arterial and venous compromise by an osteochondroma

Cited by 17 publications

References 9 publications

Osteochondroma: MR imaging of tumor-related complications

Osteochondroma: MR imaging of tumor-related complications

Imaging of Osteochondroma: Variants and Complications with Radiologic-Pathologic Correlation

Benign Conditions

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