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Extra resources for Carpal Disorders
Sample text
In their case, an 11-year-old boy had mild pain but no fracture. Periosteal chondromas may cause mechanical or compressive symptoms, including carpal tunnel syndrome [32]. Malignant change is very rare in solitary chondromas, and it has not been reported in the carpus. Enchondromas replace normal medullary bone, creating radiographically well-defined margins. In the hand, enchondromas may be quite expansive, commonly causing endosteal scalloping and significant cortical thinning. Chondral calcification occurs throughout the lesion and appears as rings and arcs on plain radiograph; a ‘‘stippled’’ appearance.
Resection of the nidus is curative [19,20,22] and recurrence is rare [16,23]. The authors pack the defect with local cancellous bone graft, although removing the lesion is clearly the most important factor in pain relief [22]. A recent study [24] demonstrated successful treatment of osteoid osteomas of the upper extremity using radiofrequency ablation; however, this technique is not currently recommended for the carpal bones because of the proximity of neurovascular structures. Enchondroma A chondroma is a benign cartilaginous neoplasm of bone.
Segalman, MDb a Curtis National Hand Center, Union Memorial Hospital, 3333 North Calvert Street, 2nd Floor, Baltimore, MD 21218, USA b Department of Orthopaedic Surgery, Johns Hopkins School of Medicine, 601 North Caroline Street, Baltimore, MD 21287-0765, USA Wrist pain is one of the most common complaints seen by a hand or orthopedic surgeon. The proximate cause is often obvious, but a cursory examination may allow the clinician to miss significant underyling pathology (Fig. 1). A careful, thorough examination is warranted, even when the diagnosis seems apparent.
