INTRAOSSEOUS LESION OF PHALANX: TWO SIMILAR CASES BUT NOT THE SAME

Abstract

Intraosseous lesions at phalanges are rare. They frequently present with pain and swelling. Fortunately, majority of the lesions are benign. However, some lesions are destructive and early interventions are required. We report two cases of similar presentations of swelling and discomfort at little finger for six months. The lytic lesions involved the whole middle phalanx with cortical breach sparing joints. Diagnosis was impossible with imaging alone. Bone biopsy was performed early to plan definitive treatment and surgery. Patient 1 was diagnosed for intraosseous gout whereas Patient 2 for epithelioid hemangioma. Both were benign destructive bone lesions. Thus, we counselled for curettage of lesion, bone grafting and spanning external fixation in view of extensive lesion. Patient 1 had defaulted treatment. Patient 2 had uneventful surgery. She regained her grip strength. In two years follow up, there was no evidence of infection, recurrence or malignant transformation.