The clinical presentation of an enchondroma depends on its size or extent and location. In general, an enchondroma is asymptomatic and therefore usually an incidental finding on radiography. The following symptoms and complaints may indicate an enchondroma: Main symptoms Local bulbous distension (swelling) of the affected bone – especially in the hand quickly visible from … Enchondroma: Symptoms, Complaints, Signs
Pathogenesis (development of disease) An enchondroma originates from cartilage tissue. It consists of mature chondrocytes (cartilage cells) and has a hyaline matrix typical of cartilage, which is characterized by high pressure elasticity. The chondrocytes are benign (benign) in nature. Due to growth, an enchondroma thins the cortical bone (outer layer of bone) from the inside … Enchondroma: Causes
General measures Nicotine restriction (refraining from tobacco use). Limited alcohol consumption (men: max. 25 g alcohol per day; women: max. 12 g alcohol per day). Limited caffeine consumption (max 240 mg of caffeine per day; equivalent to 2 to 3 cups of coffee or 4 to 6 cups of green/black tea). Aim for normal weight! … Enchondroma: Therapy
As soon as an enchondroma causes discomfort, it must be resected. Other indications for surgical intervention include: Enchondroma close to the trunk – femur (thigh bone) and humerus (upper arm bone) – or located in the trunk skeleton. → risk of degeneration → more expansive behavior → tendency to relapse (recurrence of the disease). More … Enchondroma: Surgical Therapy
Medical history (history of illness) represents an important component in the diagnosis of enchondroma. Family history Are there any diseases in your family that are common? (Tumor diseases) Social anamnesis Current medical history/systemic history (somatic and psychological complaints). Have you noticed any swelling or deformity in the joints and/or bones* ? Do you suffer from … Enchondroma: Medical History
Musculoskeletal system and connective tissue (M00-M99). Fibrous dysplasia – malformation of bone tissue, that is, the bones form tumor-like projections. Ischemic bone necrosis (“bone infarction”) – demise of bone tissue. Neoplasms – tumor diseases (C00-D48). Other bone tumors – chondrosarcoma, giant cell tumor of the hand. Injuries, poisonings and other consequences of external causes (S00-T98). … Enchondroma: Or something else? Differential Diagnosis
The following are the most important diseases or complications that can be caused by enchondroma: Neoplasms – Tumor diseases (C00-D48). Malignant (malignant) degeneration → chondrosarcoma, secondary (very rare). Injuries, poisoning, and other consequences of external causes (S00-T98). Pathologic fractures (broken bones) – due to the bone tumor, the affected bone loses strength
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin and mucous membranes Neck Extremities: [swelling? Size; consistency; displaceability of skin relative to underlying surface. Deformity of joints and bones?] Spine, thorax (chest). Auscultation (listening) of the heart. … Enchondroma: Examination
Laboratory parameters of the 1st order – obligatory laboratory tests. Biopsy (tissue sample) – Is required only if malignant (malignant) tumor cannot be excluded.
Therapeutic targets In case of symptoms: surgical removal of the enchondroma (see “Surgical therapy“). Restoration/maintenance of mobility Relief of pain Therapy recommendations Analgesia (pain relief) according to WHO staging scheme: Non-opioid analgesic (paracetamol, first-line agent). Low-potency opioid analgesic (e.g., tramadol) + non-opioid analgesic. High-potency opioid analgesic (eg, morphine) + non-opioid analgesic.
Obligatory medical device diagnostics. Conventional radiograph of the affected body region, in two planes – enchondromas are centrally located and sharply demarcated; also characteristic are spatter-like calcifications (“popcorn-like”) and an absent cancellous structure Computed tomography (CT; sectional imaging procedure (X-ray images from different directions with computer-based evaluation)) – if malignancy (malignancy) can not be ruled … Enchondroma: Diagnostic Tests
