Symptoms

In the hand, many enchondromas become noticeable by a gradually occurring, slowly increasing swelling in the area of the bone affected by the enchondrome. It is not uncommon, however, for enchondromas to be discovered during an X-ray examination of the hand that was performed for completely different reasons (e.g. after an accident).

Metastasis

Enchondromas can degenerate malignant with a probability of 20%. In cases where enchondromas have already colonized the larger tubular bones or the pelvis, the probability of malignant degeneration is increased. In summary, degeneration is more likely to occur the more often it occurs, or if it has already spread to areas outside the small bones of the hand and foot. Enchondromas do not metastasize.

Diagnosis

As a rule, X-ray diagnostics is consulted for diagnosis. As a rule, central, oval osteolysis will then become visible. In addition, in cases of spontaneous fractures, the cortical bone (= outer, hard layer of bone) may be affected.

X-ray diagnostics alone often does not allow a reliable diagnosis. Although characteristic changes in an enchondrome can be seen on the X-ray image, such changes are also visible in other (possibly malignant) tumors. Ultimately, only the fine tissue (histological) examination of the tumor tissue provides information.

Such histological examinations are generally performed routinely during surgical removal. In order to be able to assess an enchondrome, imaging must be performed. The most common, cheapest and easiest imaging procedure is an x-ray.

Accordingly, if an enchondrome is suspected, an x-ray is usually taken first. This is often sufficient for evaluation. If this is not the case, an additional MRI (magnetic resonance imaging) can be performed.Computer tomographic examinations can also be considered, but are associated with a significantly higher radiation exposure than X-rays or MRI.

Complications

Every operation involves a certain amount of risk. This can never be excluded from the outset. For example, disturbances in wound healing or, in rare, severe cases, severe infection of the bone cavity can occur during this operation.

These complaints are then treated with antibiotics, and rarely a follow-up operation is necessary. Since enchondromas are differently localized, different difficulties can occur in the course of an operation, depending on the individual situation. For example, injuries in the area of tendons and/or nerves cannot be ruled out.

Especially if the enchondrome is located near the joint, mobility disorders can occur, which can be counteracted by appropriate therapeutic measures. Another surgical risk is Sudeck’s syndrome, Sudeck’s disease (CRPS), which occurs particularly after fractures and soft tissue injuries, inadequate immobilization,. It can occur after multiple reduction or after traumatizing surgical techniques.

The result is a painful mobility disorder. To learn more about this topic please click on the link. In case of planned operations, you should stop taking blood-thinning medication (e.g. aspirin, ASS, Marcumar, etc.)

in agreement with your treating physician about 10 – 12 days before the planned operation. Consultation with your treating physician is important because some patients continue to have reduced blood clotting even after discontinuing the preparations and this may still have to be treated with heparin before the operation. Many patients show that the intake of the above mentioned drugs can be interrupted for a few weeks.

Only their attending physician can determine which of the two groups they belong to. ! Please also note that in case of toothache and/or headaches, unconscious taking of aspirin should be avoided for 10-12 days before the operation. In severe cases, please choose painkillers that do not have blood-thinning properties. Paracetamol should be mentioned here as an example.