Epiphyseal pseudotumor of the tibia:an uncommon presentation of osteoarthritis

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Wafa Hamdi
Dhia Kaffel
Hanene Ferjani
Kawther Maatallah
Hend Riahi
Mohamed Montacer Kchir

Abstract

Epiphyseal pseudotumor secondary to osteoarthritis are rare in patients under 50 years. We report here the case of a 48-year-old woman who complained of pain in the medial side of the left knee for three years. X-rays of the left knee showed a large lytic lesion containing multiple septae, with sclerotic margins at the upper end of the tibia, associated with knee osteoarthritis. An epiphyseal tumor of the left tibia was suspected. CT scan of the left knee concluded in a giant subchondral cyst secondary to osteoarthritis. Subchondral cysts or geodes are a common finding in patients with knee osteoarthritis. Nevertheless, some unusual aspects of the lesions may lead to diagnosis difficulties.

Keywords:

subchondral cyst, osteoarthritis, pseudo tumor

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References

  1. Crema MD, Roemer FW, Zhu Y, Marra MD, Niu J, Zhang Y, Lynch JA et al. Subchondral cystlike lesions develop longitudinally in areas of bone marrow edema-like lesions in patients with or at risk for knee osteoarthritis: detection with MR imaging--the MOST study.Radiology. 2010 ;256:855-62.
  2. Zanetti M ,Bruder E , Romero J , Hodler J. Bone marrow edema pattern in osteoarthritic knees: correlation between MR imaging and histologic findings . Radiology 2000 ; 215: 835 - 840 .
  3. Wu H, Webber C, Fuentes CO, Bensen R, Beattie K, Adachi JD, et al. Prevalence of knee abnormalities in patients with osteoarthritis and anterior cruciate ligament injury identified with peripheral magnetic resonance imaging: a pilot study. Can AssocRadiol J. 2007;58:167-175.
  4. Tanamas SK, Wluka AE, Pelletier JP, Martel-Pelletier J, Abram F, Wang Yet al. The association between subchondralbone cysts and tibial cartilage volume and risk of joint replacement in people with knee osteoarthritis: a longitudinal study. Arthritis Res Ther. 2010;12:R58.
  5. Bianchi S, Abdelwahab IF, Zwass A, Rettagliata F, Federici E, Ricci G. Expansile subchondral degenerative bone cyst secondary to osteoarthritis. Can AssocRadiol J 1995; 46:308-10.
  6. Ostlere SJ, Seeger LL, Eckardt JJ. Subchondral cysts of the tibia secondary to osteoarthritis of the knee. Skeletal Radiol 1990;19:287-9.
  7. Conway WF, Hayes CW. General case of the day. Giant osteoarthritic subchondral cyst with a pathologic fracture. Radiographics1988 ;8:818-22.
  8. Crawford R., Sabokbar A., Wulke A., Murray D. W., Athanasou N.A. Expansion of an osteoarthritic cyst associated with wear debris. J Bone Joint Surg [Br] 1998;80:990-3.
  9. Hunter DJ, Zhang YQ, Tu X, et al. Change in joint space width: Hyaline articular cartilage loss or alteration in meniscus? Arthritis Rheum 2006; 54: 2488-95.
  10. Brandt KD, Dieppe P, Radin EL. Commentary: is it useful to subset "primary" osteoarthritis? A critique based on evidence regarding the etiopathogenesis of osteoarthritis. Seminars in Arthritis Rheum. 2009; 35: 81-95.
  11. Williams HJ, Davies AM, Allen G, Evans N, Mangham DC. Imaging features of intraosseous ganglia: a report of 45 cases. EurRadiol. 2004 ;14:1761-9.
  12. Bancroft L.W, PetersonJ.J ,KransdorfM.J. Cysts, geodes, and erosions. RadiolClin North Am2004; 41: 73-87.
  13. Gould CF, Ly JQ, Lattin GE Jr, Beall DP, Sutcliffe JB 3rd. Bone tumor mimics: avoiding misdiagnosis.CurrProblDiagnRadiol. 2007;36:124-41.
  14. Raynauld JP, Martel-Pelletier J, Berthiaume MJ, Abram F, Choquette D, Haraoui B. Correlation between bone lesion changes and cartilage volume loss in patients with osteoarthritis of the knee as assessed by quantitative magnetic resonance imaging over a 24-month period. Ann Rheum Dis. 2008;67:683-688.
  15. Malghem J, Omoumi P, Lecouvet FE, Vande Berg BC. Presumed intraarticular gas microbubbles resulting from a vacuum phenomenon: visualization with ultrasonography as hyperechoic microfoci.SkeletalRadiol. 2011; 40:1287-93.