Intraosseous lesion of phalanx: Two similar cases but not the same

Intraosseous lesions at phalanges are rare. They frequently present with pain and swelling. Fortunately, the majority of the lesions are benign. However, some lesions are destructive and early interventions are required. We report two cases of similar presentations of swelling and discomfort at the...

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Bibliographic Details
Main Authors: Gunasagaran, Jayaletchumi, Chung, Weng Hong, Shivdas, Sachin, Amir, Shams, Khoo, Saw Sian, Chandran, Patricia Ann, Ahmad, Tunku Sara
Format: Article
Published: University of Malaya Medical Centre 2019
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Online Access:http://eprints.um.edu.my/24135/
https://jummec.um.edu.my/article/view/14152
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Institution: Universiti Malaya
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Summary:Intraosseous lesions at phalanges are rare. They frequently present with pain and swelling. Fortunately, the majority of the lesions are benign. However, some lesions are destructive and early interventions are required. We report two cases of similar presentations of swelling and discomfort at the little finger for six months. The lytic lesions involved the whole middle phalanx with cortical breach sparing the joints. A provisional diagnosis of osteomyelitis was made, although unlikely. Bone biopsy was performed early to plan for definitive treatment and surgery. Patient 1 was diagnosed for intraosseous gout whereas Patient 2 for epithelioid hemangioma. Both were benign destructive bone lesions. Thus, we counselled the patients for curettage of lesion, bone grafting and spanning external fixation in view of extensive lesion. Patient 1 defaulted treatment. Patient 2 had an uneventful surgery. She regained her grip strength. In two years follow up, there was no evidence of infection, recurrence or malignant transformation. © 2019, Faculty of Medicine, University of Malaya. All rights reserved.