Rameez Raja, Ul-Hassan Mehmood, Kotwal Hilal A, Kangoo Khursheed A H, Nazir Asif
Department of Orthopaedics, Government Medical College Srinagar, Jammu and Kashmir, Himachal Pradesh, India.
J Orthop Case Rep. 2016 Nov-Dec;6(5):96-99. doi: 10.13107/jocr.2250-0685.652.
Osteochondroma or exostosis is most common benign bone tumors. They are usually seen in the metaphyses of long bones with more than 35% of cases affecting the bone around the knee and are seldom found in flat bones like scapula. When present in scapula, they may cause abnormal scapulothoracic movements leading to pain, snapping, and pseudowinging of scapula.
We describe a novel case of osteochondroma arising on the ventral aspect of right scapula in a 16-year-old otherwise healthy female patient causing snapping and pseudowinging of scapula and occasional pain in affected area. X-ray and computed tomography findings were consistent with an abnormal bony mass arising on ventral aspect of superior border of the scapula. The patient was treated with open extraperiosteal resection of the mass with relief of symptoms. The histopathological diagnosis was consistent with osteochondroma with no signs of malignancy.
In a patient with winging and snapping of scapula one should be aware of rare diagnosis osteochondroma along with other more common etiology.
骨软骨瘤或外生骨疣是最常见的良性骨肿瘤。它们通常见于长骨的干骺端,超过35%的病例影响膝关节周围的骨骼,很少见于肩胛骨等扁骨。当出现在肩胛骨时,它们可能导致肩胛胸壁运动异常,引起疼痛、弹响和肩胛骨假性翼状肩胛。
我们描述了一例16岁健康女性患者右肩胛骨腹侧出现骨软骨瘤的罕见病例,该肿瘤导致肩胛骨弹响和假性翼状肩胛,且患区偶尔疼痛。X线和计算机断层扫描结果与肩胛骨上缘腹侧出现的异常骨块一致。患者接受了肿物的开放性骨膜外切除术,症状缓解。组织病理学诊断与骨软骨瘤一致,无恶性迹象。
对于出现肩胛骨翼状肩胛和弹响的患者,除了其他更常见的病因外,应警惕罕见的骨软骨瘤诊断。