Small sharp exostosis tip in solitary osteochondroma causing intermittent knee pain due to pseudoaneurysm

BMC Res Notes. 2013 Apr 10;6:142. doi: 10.1186/1756-0500-6-142.


Background: Complications of solitary or multiple osteochondromas are rare but have been reported in recent literature. Most reported complications arose in patients with multiple and/or sizable osteochondromas.

Case presentation: A 22-year-old, female, Caucasian patient with obesity presented with intermittent knee pain and hematoma of the right calf. The MRI depicted a small, sharp exostosis tip of the dorsal distal femur with a surrounding soft-tissue mass. After profuse bleeding occurred during biopsy of the soft tissue mass, angiography revealed a pseudoaneurysm of the right popliteal artery. In a second-stage surgery the exostosis tip and pseudoaneurysm were resected.

Conclusion: Complications can also arise in small, seemingly harmless osteochondromas. Surgical resection should be considered as a preventive measure when exostoses form sharp tips close to neurovascular structures regardless of total osteochondroma size.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aneurysm, False / complications
  • Aneurysm, False / diagnosis*
  • Angiography
  • Biopsy
  • Exostoses / diagnosis*
  • Exostoses / etiology
  • Female
  • Hematoma
  • Humans
  • Knee / physiopathology*
  • Magnetic Resonance Imaging
  • Obesity
  • Osteochondroma / complications*
  • Osteochondroma / diagnosis*
  • Pain / diagnosis*
  • Young Adult