Proximal Ulna: A Rare Location for Solitary Intraosseous Hemangioma

Shikhare, Sumer N.; Sittampalam, Kesavan; Peh, Wilfred C. G.; Shimpi, Trishna

doi:10.5001/omj.2018.48

Cited by 5 publications

(7 citation statements)

References 6 publications

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“…Hemangioma is a rare bone lesion with a preponderance in females, with most patients being young adults and female patients younger than their male counterparts [ 2 ]. Contrary to vertebral or skull hemangiomas which are mostly asymptomatic, extremity hamgiomas are symptomatic in most patients, with local swelling or a soft tissue mass in 77% [ 2 , 4 , 12 ]. Pathological fractures are uncommon and may be the initial clinical presentation in less than 10% of patients.…”

Section: Discussionmentioning

confidence: 99%

“…Radiological presentations of hemangiomas in the long bones are highly variable and non-specific and are difficult for a correct diagnosis [ 4 ] because diverse matrix found in the bone hemangioma like vessels, fat, fibrous tissue, smooth muscles, and clotted blood may all account for the variable radiological presentations [ 13 , 14 ]. The medullary type mainly occurred at the diaphysis or metaphysis with few involvement of the epiphysis.…”

Section: Discussionmentioning

confidence: 99%

“…On MRI, the long bone hemangioma may demonstrate low, intermediate or high signal intensity on T1WI. Hyperintense signal on T1WI may be caused by the fat content within the lesion, whereas hyperintense signal on T2WI may be due to the fluid content of the tumor vessels [ 4 ]. Characteristically hypointense signal of the internal trabecular may be shown on the T1WI and T2WI in the long bone hemangioma [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…Osseous hemangioma accounts for 1% of all primary skeletal neoplasms with about 75% in the vertebra or skull and 15%-20% in the scapula, ribs, clavicle and pelvic bones [ 1 – 4 ]. Osseous hemangioma is frequently solitary but may be multiple.…”

Section: Introductionmentioning

confidence: 99%

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Imaging features of hemangioma in long tubular bones

Cao

Wen

Han

et al. 2021

BMC Musculoskelet Disord

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Background To investigate the imaging features of hemangiomas in long tabular bones for better diagnosis. Methods Twenty-four patients with long bone hemangiomas confirmed by pathology were enrolled. Nineteen patients had plain radiography, fourteen patients had computed tomography (CT) and eleven had magnetic resonance imaging (MRI). The hemangioma was divided into medullary [13], periosteal [6] and intracortical type [5]. Results Among 19 patients with plain radiography, eleven patients were medullary, three periosteal, and five intracortical. In the medullary type, the lesion was primarily osteolytic, including five cases with irregular and unclear rims and one lesion having osteosclerotic and unclear rims. In three patients with the periosteal type, the lesion had clear rims with involvement of the cortical bone in the form of bone defect, including two cases with local thickened bone periosteum and one case having expansile periosteum. Five intracortical hemangiomas had intracortical osteolytic lesions with clear margins. Among 14 patients with CT imaging, 8 cases were medullary, three periosteal, and three intracortical. Among 8 medullary hemangiomas, one had ground glass opacity, and seven had osteolytic, expansile lesions like soft tissue density with no calcification. In three periosteal cases, the lesion was osteolytic with thickened periosteum and narrowed medullary cavity. In three intracortical hemangiomas, the lesion was of even soft tissue density with no calcification. Among 11 patients with MRI imaging, seven were medullary, two periosteal, and two intracortical. Among 7 medullary lesions, six were of hypointense signal on T1WI and hyperintensesignal on T2 WI. In two periosteal cases, the periosteum was thickened, with one case being of equal signal, and the other having no signal. Two intracortical hemangiomas were both of slightly low signal on T1WI but hyperintense signal on T2WI. Conclusions The long bone hemangiomas had characteristic cystic honeycomb-like presentations in plain radiograph. CT and MRI imagings are helpful for diagnosis of hemangiomas in long bone.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Imaging features of hemangioma in long tubular bones

Cao

Wen

Han

et al. 2021

BMC Musculoskelet Disord

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“…When found in these bones, the diagnosis is not difficult due to its typical appearance. However, it is challenging to make a firm diagnosis on imaging when IH presents in unusual locations such as a long bone [ 1 , 2 ].…”

Section: Introductionmentioning

confidence: 99%

Management of a Rare Case of Cavernous Medullary Intraosseous Hemangioma in Proximal Tibia of a 38-year-old Female

Rajani¹,

Shah²,

Mittal³

et al. 2022

JOCR

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Introduction: Intraosseous hemangiomas (IH) are one of the rarest bone tumors that an orthopedic surgeon comes across, more so in the long bones. It most often affects adult females, severely blunting their activities of daily living, coupled with potential debilitating complications such as pathological fracture. Case Presentation: We present a case of a 38-year-old female who presented with long standing pain and swelling in the left knee. Radiology, in the form of plain radiographs and magnetic resonance imaging, narrowed the diagnosis down to a benign form of osteoblastoma or hemangioma. With this in mind, the patient underwent radical excision of the lytic lesion, along with a margin of the surrounding normal bone. The defect was filled with impaction bone grafting and supplemented by a hydroxyapatite block and a poly ethyl ether ketone plate. The patient had excellent clinical, functional, and radiological outcomes at 6 months follow-up. Conclusion: With the inherent rarity of IH, especially when it affects the long bones, it has barely been reported in orthopedic literature. Subsequently, management protocols for such lesions are ill-defined, which can be deleterious to the patient as well as the surgeon. Through this case report, we show how to approach a patient presenting with associated complaints, and show a detailed outline of an efficacious management regime that gave excellent outcomes in our patient.

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Hemangioma of long tubular bone: imaging characteristics with emphasis on magnetic resonance imaging

Zhou

Yang

et al. 2020

Skeletal Radiol

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Proximal Ulna: A Rare Location for Solitary Intraosseous Hemangioma

Cited by 5 publications

References 6 publications

Imaging features of hemangioma in long tubular bones

Imaging features of hemangioma in long tubular bones

Management of a Rare Case of Cavernous Medullary Intraosseous Hemangioma in Proximal Tibia of a 38-year-old Female

Hemangioma of long tubular bone: imaging characteristics with emphasis on magnetic resonance imaging

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