The Journal of Bone and Joint Surgery, Vol 66, Issue 9 1454-1459, Copyright © 1984 by Journal of Bone and Joint Surgery, Inc
Correlative radiographic, scintigraphic, and histological evaluation of exostoses
RH Lange, TA Lange and BK Rao
We reviewed the cases of twenty-four patients with solitary or multiple
exostoses to correlate their radiographic, scintigraphic, and histological
evaluations. We studied twenty-five excised lesions, two of them exostotic
chondrosarcomas, from twenty-two patients. There were two patterns of
bone-scan activity and there was a direct correlation between enchondral
bone formation and radionuclide uptake in all patients, both skeletally
immature and mature. So-called quiescent lesions--those with inactive
scans--were those that lacked histological evidence of enchondral bone
formation. Those with increased uptake--active exostoses--all demonstrated
active formation of enchondral bone. Evidence of active exostotic growth
could be demonstrated on bone scans well beyond the time of skeletal
maturity. The bone scan did not qualitatively differentiate the benign
active exostoses from the two lesions with malignant degeneration.
Increased uptake related to enchondral bone formation was a feature of
both. An inactive scan, however, seemed to exclude the possibility of
malignant degeneration in the exostosis.
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