1. 1991-1992 Gerhard Bock Pamela Isaacs Joseph Spaeth Megan McAndless
Michael Recht
Guo-Shu Huang
Yang Hee Park
Enrique Bosch
Gerhard Boch

2. Gerhard Bock 22 year old male
6 month history of finger pain and swelling
No history of trauma

3. 22M 6 month history of finger pain and swelling No history of trauma

4. 22M 6 month history of finger pain and swelling No history of trauma

5. 22M 6 month history of finger pain and swelling No history of trauma

6. 22M 6 month history of finger pain and swelling No history of trauma

7. Findings Radiograph MRI CT with reformat Soft tissue swelling
Oval radiolucent lesion in proximal phalanx with suggestion of cortical thickening/sclerosis
Possible internal density
MRI
Soft tissue edema around phalanx
Eccentric lucency with central area of decreased signal
CT with reformat
Confirms lucency with central calcified density
Soft tissue swelling about phalanx

8. Differential dx
Osteiod osteoma
Brodies abcess

9. Diagnosis Osteiod osteoma 20% occur in hands or feet
Usually proximal phalanx or metacarpal
Males>females 3:1 usual age range 7-25yrs
Variable appearance in hands
If cortical prominent periostitis
If subperiosteal scalloping of bone
If cancellous partially or totally calcified
Prominent soft tissue swelling simulating infection or arthritis
Painless lesions appear to be more frequent in phalanges