Nora’s Lesion Excision

excruciating pain in right palm

This 42 yo male presented with a one week history of excruciating pain in the palm of his right hand in line with the ring finger.  He had virtually no finger motion due to the pain. The hand was markedly swollen over the ulnar palm with some discoloration.  This region was extremely tender to the touch. He had no history of trauma or other medical conditions.

Bizarre Parosteal Osteochondroma
Bizarre Parosteal Osteochondroma xray 2

X-rays and MRI cuts revealed a large soft tissue mass emanating from the 4th metacarpal, thought consistent with a Bizarre Parosteal Osteochondroma vs. a Sarcoma.  An excisional biopsy was performed and the pathology was consistent with the former.

Bizarre Parosteal Osteochondroma xray 3
Six months after excisional biopsy

Six months after excisional biopsy, the patient was pain free with full range of motion and no tenderness

nora's lesion post surgery xray

Final X-rays revealed benign incorporation and a course consistent with a Nora’s Lesion.

Categories: Hand