[khanar]

25 year female patient presented with pain in the hand
X ray showed these lesions

image from public domain wikimedia commons

What is the most likely diagnosis?
a- Enchondroma
b- Osteosarcoma
c- Giant cell tumor
d- Ewing sarcoma
e- Osteitis fibrosa cystica

 

[DrSeddik]

knowing that I'm not good in x rays, I choose osteitis fibrosa

 

[khanar]

The correct answer is giant cell tumor
This is the typical egg shell or soap bubble appearance of the tumor

Btwn, If I was not the maker of the question I would have chose osteitis fibrosa cystica like you

 

[monika]

The correct answer is giant cell tumor
This is the typical egg shell or soap bubble appearance of the tumor

Btwn, If I was not the maker of the question I would have chose osteitis fibrosa cystica like you

Ithink it is ewings sarcoma any body explain x-ray finding i am not good in that

 

[DrSeddik]

The site of the lesion is relatively common in osteitis fibrosa and minority of giant cell tumors which are usually found around the knee. The age is not appropriate for osteitis fibrosa, anyway the x ray is not typical of giant cell tumor, the soap bubble (multiple septaions within a lytic lesion) appearance could be much more clear than that, the only thing that's clear here and denotes GCT is cortical invasion. Another feature is that it respects the articular surface boundaries. try these:
http://medinfo.ufl.edu/~mspath/sample/images/e11046.jpg
http://emedicine.medscape.com/article/389833-imaging

This picture is taken from wikipedia giant cell tumor of the hand.

Ewing's occurs in younger population, it may present as osteomyelitis (redness, fever...). It arises from the diaphesis, the tumor is very aggressive infiltrating soft tissue. It occurs in long bone especially the femur and in pelvic bones. It produces onion skinning (layered appearance)

 

[XY-Linked]

my answer: a- Enchondroma

because Enchondroma is the most common type of hand tumor
and it is most common in the hand, but may also affect the femur, humerus, and the tibia

The most common symptoms are:
1- pain of the affected area
2-enlargement of the affected finger
3-slow bone growth in the affected area

or could be asymptomatic