Beaks and peaks in adult skeleton, Part I: Bony excrescences in skull base and upper extremity

Zehra Akkaya, Ayşegül Gürsoy Çoruh, Gülden Şahin

Abstract


Bony protrusions which may be part of normal or vari- ant anatomy or de novo pathologic conditions can have particular imaging and clinical findings. They can arise as a result of overuse injuries and trauma. Additionally, some bony spurs may have an evolutionary base. Some of them can result from a previous injury whereas some others are the reason for the injury of neighbouring structures themselves. Presenting symptoms may also vary accordingly, from being asymptomatic, where the lesions are detected incidentally, to being associated with severe pain and limited range of motion due to im- pingement and mass effect on the surrounding tissues. The purpose of this pictorial review is to overview some common and some infrequent but important bony ex- crescences, by emphasising on their clinical importance and differential diagnoses based on their imaging find- ings. This first part of the review covers the skull base and upper extremity with emphasis on the latter.


Keywords


bone spur; exostoses; osteophyte; radiography; upper extremity

Full Text:

PDF

References


Morgan H, Damron T, Cohen H, et al. Pseudotumor deltoideus: a previously undescribed anatomic variant at the deltoid insertion site. Skeletal Radiol 2001; 30: 512-518.

Wiegerinck JI, Vroemen JC, van Dongen TH, et al. The posterior impingement view: an alternative conventional projection to detect bony posterior ankle impingement. Arthroscopy 2014; 30: 1311-1316.

Conway WF, Destouet JM, Gilula LA, et al. The carpal boss: an overview of radiographic evaluation. Radiology 1985; 156: 29-31.

Bennett GE. Shoulder and elbow lesions distinctive of baseball players. 1947. Clin Orthop Relat Res 2012; 470: 1531-1533.

Ceylan A, Koybasioglu A, Celenk F, et al. Surgical treatment of elongated styloid process: experience of 61 cases. Skull Base 2008; 18: 289-295.

Radak D, Tanaskovic S, Kecmanovic V, et al. Bilateral Eagle syndrome with associated internal carotid artery kinking and significant stenosis. Ann Vasc Surg 2016; 34: 271. e15-18.

Chang CA, Lin T, Fung K, et al. Isolated Horner syndrome from an elongated styloid process (Eagle syndrome). J Neuroophthalmol 2015; 35: 387-389.

Bafaqeeh SA. Eagle syndrome: classic and carotid artery types. J Otolaryngol 2000; 29: 88-94.

Resnick D, Kransdorf MJ. Enostosis, hyperostosis, and periostitis. In: Resnick D, Kransdorf MJ (eds). Bone and Joint Imaging. Elsevier Saunders, Philadelphia 2005, pp 1424-1425.

Shahar D, Sayers MGL. Prominent exostosis projecting from the occipital squama more substantial and prevalent in young adult than older age groups. Sci Rep 2018; 8: 3354.

Touska P, Hasso S, Oztek A, et al. Skull base ligamentous mineralisation: evaluation using computed tomography and a review of the clinical relevance. Insights Imaging 2019; 10: 55.

Kjaer M, Langberg H, Heinemeier K, et al. From mechanical loading to collagen synthesis, structural changes and function in human tendon. Scand J Med Sci Sports 2009; 19: 500-510.

Karcich J, Kazam JK, Rasiej MJ, et al. Bennett lesions in overhead athletes and associated shoulder abnormalities on MRI. Skeletal Radiol 2019; 48: 1233-1240.

Pohlgeers KM, Becker JA. Infraspinatus atrophy in a volleyball player: a case of a bennett lesion causing nerve impingement. Curr Sports Med Rep 2014; 13: 358-360.

De Maeseneer M, Jaovisidha S, Jacobson JA, et al. The Bennett lesion of the shoulder. J Comput Assist Tomogr 1998; 22: 31-34.

Miniaci A, Mascia AT, Salonen DC, et al. Magnetic resonance imaging of the shoulder in asymptomatic professional baseball pitchers. Am J Sports Med 2002; 30: 66-73.

Stoller DW, Wolf EM, Li AE, et al. The Shoulder. In: Stoller (ed). Magnetic resonance imaging in orthopaedics and sports medicine. Lippincott Williams and Wilkins, Philadelphia, 2007, pp 1353-1357.

Murphey MD, Choi JJ, Kransdorf MJ, et al. Imaging of osteochondroma: variants and complications with radiologic-pathologic correlation. Radiographics 2000; 20: 1407-1434.

Resnick D, Kransdorf MJ, Greenway GD. Tumors and tumor-like lesions of bone: Imaging and pathology of specific lesions. In: Resnick D, Kransdorf MJ (eds). Bone and Joint Imaging. Elsevier Saunders, Philadelphia 2005, pp 1146-1154.

Khurana J, Bovée JVMG. Osteochondroma. In: Fletcher CDM, Mertens F (eds). World Health Organization classification of tumours pathology and genetics of tumours of soft tissue and bone. IARC Press, Lyon, 2002, pp 234-237.

Kitsoulis P, Galani V, Stefanaki K, et al. Osteochondromas: review of the clinical, radiological and pathological features. In Vivo 2008; 22: 633-646.

Saglik Y, Altay M, Unal VS, et al. Manifestations and management of osteochondromas: a retrospective analysis of 382 patients. Acta Orthop Belg 2006; 72: 748-755.

Peh WC, Shek TW, Davies AM, et al. Osteochondroma and secondary synovial osteochondromatosis. Skeletal Radiol 1999; 28: 169-174.

Sivananda P, Rao BK, Kumar PV, et al. Osteochondroma of the ventral scapula causing scapular static winging and secondary rib erosion. J Clin Diagn Res 2014; 8: LD03-05.

Meltzer CC, Scott WW Jr, McCarthy EF. Case report 698: Osteoma of the clavicle. Skeletal Radiol 1991; 20: 555-557.

Inokuchi T, Hitora T, Yamagami Y, et al. Parosteal osteoma of the clavicle. Case Rep Orthop 2014; 2014: 824959.

Gardner EJ, Plenk HP. Hereditary pattern for multiple osteomas in a family group. Am J Hum Genet 1952; 4: 31-36.

Hang JF, Chen PC. Parosteal osteosarcoma. Arch Pathol Lab Med 2014; 138: 694-699.

Bertoni F, Unni KK, Beabout JW, et al. Parosteal osteoma of bones other than of the skull and face. Cancer 1995; 75: 2466-2473.

Sundaram M, Falbo S, McDonald D, et al. Surface osteomas of the appendicular skeleton. AJR Am J Roentgenol 1996; 167: 1529-1533.

Hansford BG, Pytel P, Moore DD, et al. Osteoma of long bone: an expanding spectrum of imaging findings. Skeletal Radiol 2015; 44: 755-761.

Lambiase RE, Levine SM, Terek RM, et al. Long bone surface osteomas: imaging features that may help avoid unnecessary biopsies. AJR Am J Roentgenol 1998; 171: 775-778.

Pecina M, Boric I, Anticevic D. Intraoperatively proven anomalous Struthers’ ligament diagnosed by MRI. Skeletal Radiol 2002; 31: 532-535.

Shivaleela C, Suresh BS, Kumar GV, et al. Morphological study of the supracondylar process of the humerus and its clinical implications. J Clin Diagn Res 2014; 8: 1-3.

.

Ivins GK. Supracondylar process syndrome: a case report. J Hand Surg Am 1996; 21: 279-281.

Cerezal L, del Pinal F, Abascal F, et al. Imaging findings in ulnar-sided wrist impaction syndromes. Radiographics 2002; 22: 105-121.

Fusi S, Watson HK, Cuono CB. The carpal boss. A 20-year review of operative management. J Hand Surg Br 1995; 20: 405-408.

Cuono CB, Watson HK. The carpal boss: surgical treatment and etiological considerations. Plast Reconstr Surg 1979; 63: 88-93.

Wissinger HA, McClain EJ, Boyes JH. Turret exostosis. Ossifying hematoma of the phalanges. J Bone Joint Surg Am 1966; 48: 105-110.

Orui H, Ishikawa A, Tsuchiya T, et al. Magnetic resonance imaging characteristics of bizarre parosteal osteochondromatous proliferation of the hand: a case report. J Hand Surg Am 2002; 27: 1104-1108.

Nora FE, Dahlin DC, Beabout JW. Bizarre parosteal osteochondromatous proliferations of the hands and feet. Am J Surg Pathol 1983; 7: 245-250.

Vlychou M, Gibbons CL, Rigopoulou A, et al. Bizarre parosteal osteochondromatous proliferation of the clavicle. J Shoulder Elbow Surg 2008; 17: e18-20.

Abramovici L, Steiner GC. Bizarre parosteal osteochondromatous proliferation (Nora’s lesion): a retrospective study of 12 cases, 2 arising in long bones. Hum Pathol 2002; 33: 1205-1210.

Bush JB, Reith JD, Meyer MS. Bizarre parosteal osteochondromatous proliferation of the proximal humerus: case report. Skeletal Radiol 2007; 36: 535-540.

Smith NC, Ellis AM, McCarthy S, et al. Bizarre parosteal osteochondromatous proliferation: a review of seven cases. Aust N Z J Surg 1996; 66: 694-697.

Ting BL, Jupiter JB. Recurrent bizarre parosteal osteochondromatous proliferation of the ulna with erosion of the adjacent radius: case report. J Hand Surg Am 2013; 38: 2381-2386.

Cooper PN, Malcolm AJ. A bizarre parosteal osteochondromatous proliferation of the radius. Histopathology 1993; 22: 78-80.

Spjut HJ, Dorfman HD. Florid reactive periostitis of the tubular bones of the hands and feet. A benign lesion which may simulate osteosarcoma. Am J Surg Pathol 1981; 5: 423-433.

Yuen M, Friedman L, Orr W, et al. Proliferative periosteal processes of phalanges: a unitary hypothesis. Skeletal Radiol 1992; 21: 301-303.

Horiguchi H, Sakane M, Matsui M, et al. Bizarre parosteal osteochondromatous proliferation (Nora’s lesion) of the foot. Pathol Int 2001; 51: 816-823.

Dhondt E, Oudenhoven L, Khan S, et al. Nora’s lesion, a distinct radiological entity? Skeletal Radiol 2006; 35: 497-502.

Broehm CJ, M’Lady G, Bocklage T, et al. Bizarre parosteal osteochondromatous proliferation: a new cytogenetic subgroup characterized by inversion of chromosome 7. Cancer Genet 2013; 206: 402-405.

Kuruvilla S, Marco R, Raymond AK, et al. Bizarre parosteal osteochondromatous proliferation (Nora’s lesion) with translocation t(1;17)(q32;q21): a case report and role of cytogenetic studies on diagnosis. Ann Clin Lab Sci 2011; 41: 285-287.

Milgram JW. The origins of osteochondromas and enchondromas. A histopathologic study. Clin Orthop Relat Res 1983: 264-284.

Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis 1957; 16: 494-502.

Lanyon P, O’Reilly S, Jones A, et al. Radiographic assessment of symptomatic knee osteoarthritis in the community: definitions and normal joint space. Ann Rheum Dis 1998; 57: 595-601.

Ravaud P, Dougados M. Radiographic assessment in osteoarthritis. J Rheumatol 1997; 24: 786-791.

Derrick EK, Darley CR, Tanner B. Bizarre parosteal osteochondromatous proliferations of the tubular bones of the hands and feet. Clin Exp Dermatol 1994; 19: 53-55.

Shimoyama T, Yamamoto Y, Kuroda M, et al. Cortical bone remodeling in parosteal osteosarcoma mimicking medullary involvement: a case with the difficulty in pre-surgical staging. Tohoku J Exp Med 2014; 233: 165-169.




DOI: http://dx.doi.org/10.36162/hjr.v5i1.331

Refbacks

  • There are currently no refbacks.