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Clinical presentation:
30 year old man with a history of pain in the left middle finger, relieved by aspirin.

There is sclerosis of the proximal phalanx of the left middle finger. This takes the form of a peripheral mid-diaphyseal fairly well-defined 4mm. lucency and adjacent related cortical thickening.

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The isotope bone scans show increased flow and an increase in the late uptake in the region of the suspect lesion. The location is unusual, but the appearance and presentation typical for this pathology.

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[Differential]

cases that might resemble this pathology

[View large image] Chondrosarcoma. (case report) [View large image] Tuberculosis. (case report). Include osteomyelitis.
[View large image] Sarcoidosis. (case report) [View large image] Enchondromatosis. (case report)
[View large image] Sickle-cell anaemia. (case report) [View large image] Fibrous dysplasia. (case report)
[View large image] Paget's disease. (case report) [View large image] Hyperparathyroidism. (case report)
[View large image] Gout (case report) [View large image] Haemangioma (case report)
[View large image] Inclusion dermoid. (case report) Histiocytosis X, Lytic metastasis and myelomatosis are not common in the hands, but are listed, for completeness.
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[London South Bank U.]

IDM April 2007