title: Osteolytic lesions of hand and feet: a seven-year experience from a tertiary referral centre of North India.
abstract: There are 106 bones in hands and feet but their lesions are not commonly reported. This was a retrospective study of all osteolytic lesions involving bones of the hands or feet presenting to the only tertiary referral centre of the north Indian state of Uttarakhand during the 7-year period from January 2006 to December 2012. A compilation of the various demographic, clinical, radiological and histopathological findings was made. Of the 52 lesions encountered in the 7-year record, 75% were asymptomatic. 20 (38.4%) were benign tumours, 20 (38.4%) tumour-like lesions, 9 (17.3%) inflammatory and post traumatic lesions and only 3 (5.7%) were malignant lesions. Giant cell tumour was the most common benign tumour, aneurysmal bone cyst the most common tumour-like lesion and non-specific osteomyelitis was the most common inflammatory and post-traumatic pathology. All phalangeal lesions were non-malignant and 62% were either giant cell tumours or giant cell reactions. Giant cell reaction was confined to upper limb bones; metatarsals were afflicted exclusively with giant cell tumours (n=3) while malignant lesions affected the metacarpals in two and carpal bones in one instance. Aneurysmal bone cysts were seen exclusively in the tarsal (n=4) and carpal bones (n=2), a very rare finding. More cases need to be studied to define patterns of lesions of hands and feet. The definitive diagnosis is essential as many patients with osteolytic lesions may not require surgical intervention.
authors.affiliation: Swami Ram Himalayan University, Himalayan Institute of Medical Sciences, Department of Pathology, Swami Ram Nagar, Jolly Grant, Dehradun (Uttarakhand)-248140. shirazinadia@gmail.com.
authors.forename: Nadia
authors.initials: N
authors.lastname: Shirazi
authors.forename: Vibha
authors.initials: V
authors.lastname: Gupta
authors.forename: Isha
authors.initials: I
authors.lastname: Kapoor
authors.forename: Meena
authors.initials: M
authors.lastname: Harsh
authors.forename: Neena
authors.initials: N
authors.lastname: Chauhan
authors.forename: Sohaib
authors.initials: S
authors.lastname: Ahmad
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D017824:Bone Cysts, Aneurysmal / Q000000981:diagnostic imaging*; D001859:Bone Neoplasms / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005529:Foot Bones / Q000000981:diagnostic imaging*; D018212:Giant Cell Tumor of Bone / Q000000981:diagnostic imaging*; D050276:Hand Bones / Q000000981:diagnostic imaging*; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D055815:Young Adult