Findings
1. Radiograph of knee shows partially ossified lesion arising from the posterior aspect of the proximal tibial metaphysis. Axial PDFS(2) and sagittal PDFS(3) MRI images show that the lesion is continuous with the underlying tibial marrow and shows thickening of the cartilaginous component(high signal) that shows heterogeneous enhancement in the post-contrast image(4).
Diagnosis
Biopsy was done that revealed osteochondroma with sarcomatous transformation.
Summary
In cases of osteochondroma where the cartilage cap is thickened(more than 1.5cm) and shows heterogenous enhancement – biopsy should be considered to look for malignant transformation.
Further reads
https://pubs.rsna.org/doi/10.1148/radiographics.20.5.g00se171407
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