Age / Sex : 64 / M

Chief complaint : Finger pain for 2 years.

Past history : Penetrating injury by a thorn, 2 years ago.


What is your diagnosis?

Two weeks later, you can see the final diagonosis with a brief discussion of this case (Please submit only one answer).

Courtesy: 이신우(Sheen-Woo Lee), 가톨릭대학교 은평성모병원(Eunpyung St. Mary’s Hospital, The Catholic University of Korea)

Intraosseous epidermal inclusion cyst, distal phalanx.

Discussion

Findings

1.Radiograph : Expansile radiolucent lesion, distal phalanx. Thin sclerotic rim. Cortical erosion on lateral view.

2.MRI : Expansile lesion, the signal intensity diffuse low on T1, intermediate to high on T2 or FST2, extralesional enhancement.  

1. Enchondroma.


2. Chronic osteomyelitis.


3. Giant cell tumor


4. Aneurysmal bone cyst

   Epidermal inclusion cyst of phalanx: a case report and review of the literature. Patel K et al. Skeletal Radiology 2006 Nov;35(11):861-3.

   Intraosseous Epidermal Inclusion Cyst of the Proximal Phalanx of the Fifth Toe and Review of the Literature: A Case Study. Richardson M et al. Foot Ankle Spec 2017. Oct;10(5):470-472.