1991 1992 Gerhard Bock Pamela Isaacs Joseph Spaeth

1991 -1992 • • • Gerhard Bock Pamela Isaacs Joseph Spaeth Megan Mc. Andless Michael Recht Guo-Shu Huang Yang Hee Park Enrique Bosch Gerhard Boch

Gerhard Bock • 22 year old male • 6 month history of finger pain and swelling • No history of trauma

22 M 6 month history of finger pain and swelling No history of trauma

22 M 6 month history of finger pain and swelling No history of trauma

22 M 6 month history of finger pain and swelling No history of trauma

22 M 6 month history of finger pain and swelling No history of trauma

Findings • Radiograph • • Soft tissue swelling Oval radiolucent lesion in proximal phalanx with suggestion of cortical thickening/sclerosis Possible internal density MRI • • • Soft tissue edema around phalanx Eccentric lucency with central area of decreased signal CT with reformat • • Confirms lucency with central calcified density Soft tissue swelling about phalanx

Differential dx • • Osteiod osteoma Brodies abcess

Diagnosis • Osteiod osteoma • • 20% occur in hands or feet Usually proximal phalanx or metacarpal Males>females 3: 1 usual age range 7 -25 yrs Variable appearance in hands • • • If cortical If subperiosteal If cancellous prominent periostitis scalloping of bone partially or totally calcified Prominent soft tissue swelling simulating infection or arthritis Painless lesions appear to be more frequent in phalanges