Orhan BALTA, Utkan SOBAY, Fırat ERPALA, Mehmet Burtaç EREN, Çağatay ZENGİN

Erişkinlerde başka sebeplerden ötürü çekilen Manyetik Rezonans görüntülemede saptanan el enkondromlarının prevalansı.

Amaç: Manyetik rezonans görüntülemede (MRG) üst ekstremite uzun kemikleri ve el kemiklerinde tesadüfi bulgular olarak erişkinlerde enkondrom (EK) prevalansını belirlemek. Gereç ve Yöntem: 18 yaşından büyük hastalarda tesadüfi EC varlığı için üst ekstremite MRG taramalarının retrospektif bir incelemesi yapıldı. EC konumu, boyutu ve görünümü tanımlandı. Yaş, cinsiyet, MRG bölgesi, taraf, en sık görülen semptom, kemikte eksantrik veya santral yerleşim, etkilenen parmak, biyopsi varlığı, travma öyküsü varlığı ve enkondrom boyutu değerlendirildi. Bulgular: Toplam 9713 üst ekstremite MRG'si değerlendirildi. Çalışmamızda sadece üst ekstremite kemikleri için yapılan MRG'lerde tüm üst ekstremitede EC prevalansı %1.2 idi. EC en sık elin MR görüntülemesinde görüldü. Proksimal falanks en sık etkilenen kemikti. Genellikle yaşamın üçüncü ve dördüncü dekatlarında ortaya çıkar ve uzun kemiklerin ulnar tarafı etkilenir. Çalışmamızda el EC'nin genel prevalansı %4.8 idi. El enkondromlarının insidansı kadınlarda %5,8 iken erkeklerde %4,1 idi. Eldeki enkondrom insidansı omuzdakinden yaklaşık 5.77 kat daha fazlaydı. Sonuç: Bu çalışma, MR görüntüleme ile belirlenen EC prevalansı ile birlikte, elin enkondromlar için en yaygın bölge olarak düşünülmeye devam etmesi gerektiğini düşündürmektedir.

Anahtar Kelimeler:

enkondrom prevelansı, el, kısa tubuler kemik, üst ekstremite, MR

Prevalence of enchondromas of the hand in adults as incidental findings on magnetic resonance imaging.

Purpose: To determine the prevalence of enchondromas (EC) in adults as incidental findings in the long bones of the upper extremities and the bones of the hand on magnetic resonance imaging (MRI). Materials and Methods: A retrospective review of upper extremity MRI scans for the presence of incidental EC in patients older than 18 years was performed. EC location, size, and appearance were defined. Age, gender, MRI region, side, most common symptom, eccentric or central location in the bone, affected finger, presence of biopsy, presence of trauma history,and size of enchondroma were evaluated. Results: A total of 9713 upper extremity MRIs were evaluated. In our study, the prevalence of EC in the entire upper extremity was 1.2% with MRIs that performed for upper extremity bones only. EC was most commonly seen in MR imaging of the hand. The proximal phalanx was the most commonly affected bone. Often presentin the third and fourth decades of life and the ulnar side of long bones were affected. In our study, the overall prevalence of hand EC was 4.8%. While the incidence of hand enchondromas was 5.8% in females, it was 4.1% in males. The incidence of enchondromas in the hand was approximately 5.77 times higher than in the shoulder. Conclusion: This study suggests that with the prevalence of EC, as determined by MR imaging, the hand should continue to be considered the most common site for enchondromas.

Keywords:

Prevalence of enchondromas, hand, incidental findings, upper extremities, magnetic resonance imaging,

PDF

___

1. Giudici M, Moser Jr R, Kransdorf M. Cartilaginous bone tumors. Radiologic Clinics of North America. 1993;31(2):237-59.
2. Brailsford JF. The radiology of bones and joints: J. & A. Churchill; 1953.
3. Davies A, Shah A, Shah R, Patel A, James S, Botchu R. Are the tubular bones of the hand really the commonest site for an enchondroma? Clinical radiology. 2020;75(7):533-7.
4. Fletcher C, Bridge JA, Hogendoorn PCW, Mertens F. WHO Classification of Tumours of Soft Tissue and Bone: WHO Classification of Tumours, vol. 5: World Health Organization; 2013.
5. Donthineni R, Ofluoglu O. Solitary enchondromas of long bones: pattern of referral and outcome. Acta orthopaedica et traumatologica turcica. 2010;44(5):397-402.
6. Hong ED, Carrino JA, Weber KL, Fayad LM. Prevalence of shoulder enchondromas on routine MR imaging. Clinical imaging. 2011;35(5):378-84.
7. Estrada-Villaseñor E, Cedillo EAD, Martínez GR. Prevalence of bone neoplasms in adolescents and young adults. Acta ortopedica mexicana. 2008;22(5):316-20.
8. Grainger R, Stuckey S, O'Sullivan R, Davis SR, Ebeling PR, Wluka AE. What is the clinical and ethical importance of incidental abnormalities found by knee MRI? Arthritis Research & Therapy. 2008;10(1):1-6.
9. Stomp W, Reijnierse M, Kloppenburg M, de Mutsert R, Bovée JV, den Heijer M, et al. Prevalence of cartilaginous tumours as an incidental finding on MRI of the knee. European radiology. 2015;25(12):3480-7.
10. Walden MJ, Murphey MD, Vidal JA. Incidental enchondromas of the knee. American Journal of Roentgenology. 2008;190(6):1611-5.
11. Simon MJ, Pogoda P, Hövelborn F, Krause M, Zustin J, Amling M, et al. Incidence, histopathologic analysis and distribution of tumours of the hand. BMC musculoskeletal disorders. 2014;15(1):1-8.
12. Gaulke R. The distribution of solitary enchondromata at the hand. The Journal of Hand Surgery: British & European Volume. 2002;27(5):444-5.
13. Tang C, Chan M, Fok M, Fung B. Current management of hand enchondroma: a review. Hand Surgery. 2015;20(01):191-5.
14. Bauer HC, Brosjö O, Kreicbergs A, Lindholm J. Low risk of recurrence of enchondroma and low-grade chondrosarcoma in extremities: 80 patients followed for 2-25 years. Acta Orthopaedica Scandinavica. 1995;66(3):283-8.
15. Sassoon AA, Fitz-Gibbon PD, Harmsen WS, Moran SL. Enchondromas of the hand: factors affecting recurrence, healing, motion, and malignant transformation. The Journal of hand surgery. 2012;37(6):1229-34.
16. Deckers C, Schreuder BH, Hannink G, de Rooy JW, van der Geest IC. Radiologic follow‐up of untreated enchondroma and atypical cartilaginous tumors in the long bones. Journal of surgical oncology. 2016;114(8):987-91.
17. Davies A, Patel A, Azzopardi C, James S, Botchu R. Prevalence of Enchondromas of the Proximal Femur in Adults as an Incidental Finding on MRI of the Pelvis. Indian Journal of Radiology and Imaging. 2021.
18. Scherer E. Exostosen, enchondrome und ihre beziehung zum periost. Frankfurt Ztschr f Path. 1928;36:587-605.
19. Douis H, Davies A, James S, Kindblom L, Grimer R, Johnson K. Can MR imaging challenge the commonly accepted theory of the pathogenesis of solitary enchondroma of long bone? Skeletal radiology. 2012;41(12):1537-42.
20. Shimizu K, Kotoura Y, Nishijima N, Nakamura T. Enchondroma of the distal phalanx of the hand. JBJS. 1997;79(6):898-900.
21. Chou LB, Malawer MM. Analysis of surgical treatment of 33 foot and ankle tumors. Foot & Ankle International. 1994;15(4):175-81.