INTRAOSSEOUS LESION OF PHALANX: TWO SIMILAR CASES BUT NOT THE SAME

Received 2018-10-16; Accepted 2019-04-25; Published 2019-07-29

Authors

  • Jayaletchumi Gunasagaran National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Department of Orthopaedic Surgery, Faculty of Medicine, University of Malaya.
  • Weng Hong Chung National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Department of Orthopaedic Surgery, Faculty of Medicine, University of Malaya.
  • Sachin Shivdas National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Department of Orthopaedic Surgery, Faculty of Medicine, University of Malaya.
  • Shams Amir National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Department of Orthopaedic Surgery, Faculty of Medicine, University of Malaya.
  • Saw Sian Khoo National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Department of Orthopaedic Surgery, Faculty of Medicine, University of Malaya.
  • Patricia Ann Chandran Department of Pathology, Faculty of Medicine, University Malaya.
  • Tunku Sara Ahmad National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Department of Orthopaedic Surgery, Faculty of Medicine, University of Malaya.

DOI:

https://doi.org/10.22452/jummec.vol22no2.1

Keywords:

Intraosseous lesions, intraosseous gout, Epithelioid hemangioma, phalanx

Abstract

Intraosseous lesions at phalanges are rare. They frequently present with pain and swelling. Fortunately, majority of the lesions are benign. However, some lesions are destructive and early interventions are required. We report two cases of similar presentations of swelling and discomfort at little finger for six months. The lytic lesions involved the whole middle phalanx with cortical breach sparing joints. Diagnosis was impossible with imaging alone. Bone biopsy was performed early to plan definitive treatment and surgery. Patient 1 was diagnosed for intraosseous gout whereas Patient 2 for epithelioid hemangioma. Both were benign destructive bone lesions. Thus, we counselled for curettage of lesion, bone grafting and spanning external fixation in view of extensive lesion. Patient 1 had defaulted treatment. Patient 2 had uneventful surgery. She regained her grip strength. In two years follow up, there was no evidence of infection, recurrence or malignant transformation.

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Published

2019-10-03

Issue

Section

Research article

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