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Osteochondroma versus Chondrosarcoma

Malignant transformation to chondrosarcoma is seen in 1% of patients with solitary osteochondromas and 3 to 5% of patients with hereditary multiple exostoses.1 Osteochondromas that grow or cause pain after skeletal maturity should be suspected of malignant degeneration.

Features that can be used to diagnose malignant degeneration by computed tomography (CT) or magnetic resonance imaging (MRI) in a skeletally mature patient are thickness of the cartilage cap and enhancement.

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