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Related Concept Videos

Bones of the Lower Limb: Tibia and Fibula01:10

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The tibia is the main weight-bearing bone of the lower leg. It is larger than the fibula with which it is paired. The tibia is also the second longest bone in the body and is located right below the skin. The proximal end of the tibia forms the medial and the lateral condyle, which articulates with the condyles of the femur to form the knee joint. Between the articulating surfaces is the irregular elevated area known as the intercondylar eminence that serves as the inferior attachment point for...
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The femur is the body's longest and strongest bone spanning the thigh region. Its head articulates with the acetabulum of the hip bone to form the hip joint. A minor indentation on the medial side of the femoral head, called the fovea capitis, serves as the site of attachment for the ligament of the head of the femur. This weak ligament spans the femur and acetabulum and supports the hip joint. The narrowed region below the head is the neck of the femur. The inclination angle between the...
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Secondary Chondrosarcoma Arising from the Proximal Fibula Presenting as Sciatica.

Robert C Vercio1, Joseph G Elsissy2, Nadine L Williams2

  • 1Arrowhead Orthopaedics, 1801Orange Tree Lane, Redlands, CA 92374, USA.

Journal of Orthopaedic Case Reports
|December 14, 2020
PubMed
Summary

A rare secondary chondrosarcoma originating from an osteochondroma mimicked sciatica. Early diagnosis and treatment of peripheral nerve compression are crucial for better outcomes and preventing malignant transformation.

Keywords:
Sciaticachondrosarcomafibulaosteochondromasecondary

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Area of Science:

  • Orthopedic Oncology
  • Neurology
  • Radiology

Background:

  • Secondary chondrosarcoma is a rare malignant tumor arising from a pre-existing cartilaginous lesion.
  • Osteochondroma transformation to chondrosarcoma is infrequent, occurring in less than 1% of cases.
  • Sciatica, characterized by pain, weakness, and numbness, is a common condition often associated with lumbar spine issues.

Observation:

  • A 36-year-old male with a 3-year history of sciatica unresponsive to conservative treatment was evaluated.
  • Initial lumbar spine MRI revealed degenerative disc disease, but a subsequent diagnosis identified a chondrosarcoma arising from a proximal fibular osteochondroma.
  • The tumor encased the peroneal nerve, necessitating its resection along with the nerve.

Findings:

  • A chondrosarcoma arising from an osteochondroma in the proximal fibula was identified as the cause of the patient's sciatica.
  • Surgical resection of the tumor and peroneal nerve was performed.
  • The patient achieved disease-free status five years post-surgery, utilizing an ankle-foot orthosis for ambulation.

Implications:

  • This case highlights the importance of considering extraspinal lesions in patients presenting with peripheral nerve symptoms.
  • Comprehensive evaluation of the entire nerve pathway is essential for accurate diagnosis.
  • Prompt diagnosis and intervention for peripheral nerve compression can prevent malignant transformation and improve functional prognosis.