Sacral Osteochondroma-CT

Post operative follow up of left iliac osteochondroma with sacral swelling. Now with pain and restriction of motion. Young male. 

Case Report: Mixed density lesion extending from the posterior elements of the sacral vertebrae contigous with the bony cortex and extension cranially and towards right. This lesion likely indicate spinal osteochondroma. There is intraspinal extension in mid sacral level and remodelling in relation to the right sacro-iliac joint.  Patient also gives a history of previously operated for iliac blade osteochondroma which possibly indicates diaphyseal aclasis. MRI is recommended for cartilage cap evaluation.

 Although they are relatively frequently seen in the appendicular skeleton, only 1 to 4% of solitary exostoses occur in the spine. Even in patients with multiple hereditary exostoses, only 7 to 9% harbor spinal lesions.  The radiographic and CT scanning-based appearance is similar, showing continuity of normal marrow and cortex extending from normal underlying bone, without destructive change or soft-tissue mass Magnetic resonance imaging has a similar appearance, with the signal intensity mimicking that of normal marrow and cortex. Magnetic resonance imaging has the advantage of revealing the thickness of the high signal cartilage cap.