A child with painless left wrist swelling

Excerpt

Radiographs (Fig. 1) showed remodeling with an irregular expanded contour of left distal ulnar epiphysis and left lunate in particular at its ulnar aspect. Distal ulnar metaphysis was spared. The trabecular and cortical continuity of the excrescences with the parent bones were shown better on the computed tomography images (Figs. 2–4). Magnetic resonance imaging confirmed the bony enlargement (Fig. 5) and showed complete cartilage covering of the involved bones (Fig. 6). There was no involvement of distal radial epiphysis or remainder of the carpal bones. On the basis of the imaging findings, the lesions likely represented osteochondroma of the distal ulnar epiphysis and the lunate (an epiphyseal equivalent). A diagnosis of dysplasia epiphysealis hemimelica was made. The patient was followed-up clinically and remained largely asymptomatic at 2-year follow-up. The epiphyseal enlargement remained stable. …