Lytic lesions arising in the hand can be confused with an enchondroma. Enchondroma is the most common tumor of the hand and can present with varied features. It often requires only observation. A dilemma arises when surgically treatable lesions like aneurysmal bone cyst (ABC) present in uncommon locations like the hand. To diagnose a lytic lesion in the hand, percutaneous biopsy is commonly done. But, percutaneous biopsy is unnecessary in enchondroma and may not be useful in conditions like simple bone cyst and ABC. In such situations, magnetic resonance imaging (MRI) can differentiate between the most frequent benign lesions of the hand thereby reducing the need for invasive procedures. We present a 25-year-old lady who presented with a painless right index finger swelling for the past 6 months. Radiographs revealed a lytic expansile lesion in the proximal phalanx of the hand. MRI showed multiple fluid-fluid levels. Curettage and autologous iliac crest bone grafting was done. Histopathology confirmed the diagnosis of an ABC. The patient was followed up for 12 months without any recurrence. We briefly review the paucity of literature on the diagnostic approach to benign lytic lesions of the hand.
Case Rep Orthop Res 2021;4:145–151

中文翻译：

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手近节指骨溶解性病变：病例报告和诊断方法

手部发生的溶解性病变可能与内生软骨瘤混淆。内生软骨瘤是手部最常见的肿瘤，可呈现多种特征。它通常只需要观察。当手部等不常见部位存在可手术治疗的病变（如动脉瘤性骨囊肿 (ABC)）时，就会出现两难境地。为了诊断手部的溶骨性病变，通常进行经皮活检。但是，在内生软骨瘤中不需要经皮活检，并且在简单骨囊肿和 ABC 等情况下可能没有用。在这种情况下，磁共振成像 (MRI) 可以区分手部最常见的良性病变，从而减少对侵入性手术的需求。我们介绍了一位 25 岁的女士，她在过去 6 个月内出现了无痛的右手食指肿胀。X光片显示手部近节指骨有溶骨性扩张性病变。MRI 显示多个液-液水平。完成刮宫和自体髂嵴植骨。组织病理学证实了 ABC 的诊断。患者随访12个月无复发。我们简要回顾了有关手部良性溶骨性病变诊断方法的文献的缺乏。
案例代表 Orthop Res 2021；4:145–151