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The Causes of Pain in Benign Solitary Enchondromas of the Proximal Humerus.

Levy, Jonathan C MD*; Temple, H Thomas MD*; Mollabashy, Allaaddin MD*; Sanders, Jason MD*; Kransdorf, Mark MD†

Clinical Orthopaedics and Related Research (1976-2007): February 2005 - Volume 431 - Issue - pp 181-186
doi: 10.1097/01.blo.0000150114.19489.c4
SECTION II: ORIGINAL ARTICLES: Tumor
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Patients with benign solitary enchondromas of the proximal humerus frequently present to the diagnosing physician with shoulder pain. Once the lesion is considered benign, emphasis can be placed on identifying the etiology for the pain. We reviewed our experience with these patients to identify the cause of the presenting pain. A retrospective review of clinical records and radiographic studies (radiographs, magnetic resonance images, and bone scans) was done for all patients presenting to an orthopaedic oncology unit with solitary enchondroma of the proximal humerus. Attention was focused on diagnostic evidence of additional disease in the shoulder. Fifty-seven patients (mean age, 53.6 years) met the criteria of the study and were included for evaluation. Of patients presenting with pain, 82% (47 of 57 patients) had findings seen on magnetic resonance imaging scans that correlated with the initial clinical diagnostic impression, suggesting that other disease was present that could explain the pain. Solitary enchondromas of the proximal humerus often are found incidentally during the initial evaluation of patients with shoulder pain. This study showed that additional treatable disease usually is present in patients with enchondromas of the proximal humerus.

Level of Evidence: Diagnostic study, Level III-1 (study of nonconsecutive patients-no consistently applied reference gold standard)

From the *Department of Orthopaedics and Rehabilitation, University of Miami School of Medicine, Miami, FL; and the †Diagnostic Radiology, Mayo Medical Center, Jacksonville, FL.

Received: September 26, 2003

Each author certifies that he has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his institution has approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

Correspondence to: H. Thomas Temple, MD, Tissue Bank, Department of Orthopaedics, P.O. Box 016960 (R-12), Miami, FL 33101. Phone: 305-325-4475; Fax: 305-243-4622; E-mail: htemple@med.miami.edu.

© 2005 Lippincott Williams & Wilkins, Inc.