• Developmental anomaly
  • Physeal cartilage displaced to metaphyseal region
  • Knee most common site
  • Osteochondromas have a cartilaginous cap
  • Pedunculated or sessile
  • Solitary or multiple
  • Seen in multiple hereditary exostoses
  • Local pressure on adjacent structures
  • Growth after skeletal maturity and persistent pain suggest malignant change
  • Plain film
    • Bone lesion with medullary continuity arising from metaphysis quite often pointing away from the physis
  • MRI
    • Shows thickness of cartilaginous cap
    • T2 hyperintense cap
    • Cap thickness up to 3 cm in children and adolescents
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Murphey, Mark D., et al. “Imaging of osteochondroma: variants and complications with radiologic-pathologic correlation.” Radiographics 20.5 (2000): 1407-1434.

Shah, Jignesh N., et al. “Pediatric benign bone tumors: what does the radiologist need to know?: pediatric imaging.” RadioGraphics 37.3 (2017): 1001-1002.