Enchondroma - distal femur

120 views570y Female10/9/2026

Clinical Presentation

Patient fell and sustained a pertrochanteric fracture, treated with an intramedullary nail. Post op x-rays of femur were obtained to assess position.

1The pertrochanteric left femoral fracture has been fixed with a long intramedullary nail and no periprosthetic complication noted (not shown)
2There is a single distal cross bolt in good position
3Again noted is made of the 18 mm coarse clump of calcification, seen on the lateral radiograph and thought to be within the lateral femoral condyle
4Initial blood flow studies of the knees and thighs show slightly increased vascularity at the left upper femur
5Delayed whole body study and multiple views of the femur show an intense increase in tracer uptake at the upper end of the left femoral shaft particularly at the lesser trochanter
6This is consistent with the recent fracture though the intensity at the lesser trochanter appears excessive (? delayed union).In the lower femoral shaft the supracondylar region (distinct from the screw induced cortical lesions) only a minor increase in tracer uptake is noted consistent with a metabolically inactive lesion.Elsewhere there is evidence of mild spondylosis at the right side of the lower lumbar spine and the right T7 and T8 consistent with spondylosis
7The left renal upper half cortical filling defect is noted presumably a cyst but other lesions cannot be excluded
8Minor increases in tracer uptake are noted at the acromioclavicular joints consistent with osteoarthritis there or underlying supraspinatus tendinitis
9There is an irregular sclerotic lesion in the lateral metaphyseal region of the left distal femur measuring 11 x 14 x 11mm
10No cortical breakthrough, endosteal scalloping or periosteal reaction