A case of painful “enostosis” or “bone island”
Published in the journal Orthopedics & Rheumatology, the authors present a rare case of painful enostosis or bone island of a 29 years old young man complaining of pain and tender noticeable swelling at the radial aspect of the dorsum of his left wrist joint insidious onset slowly progressive course few months duration.

The patient could not recall any history of trauma, with the pain on and off, increases with physical activity of the wrist, Sometime even at rest and sleep, otherwise, he is perfectly healthy with no other complain.

On examination there was a tenderness over the base of the second metacarpal bone and a slight swelling at the site of the tenderness with no skin changes. Other than this, the ROM, power of grip and sensation are within the normal level in comparison to the other normal side.

X ray and CT scan done revealed a smooth dense cortical rounded bony lesion at the base of the second metacarpal bone with a clear even rounded edge characteristic of Bone Island. Surgical Exploration via dorsal approach, revealed erosions of the posterior cortex of the lower metaphysis of the second MC bone by the lesion which was easily removed en mass and the cavity left was filled with ipsilateral punched iliac bone graft.

Histopathology findings: Normal, mature, lamellar bone with normal architecture, and no cartilage formation or enchondral ossification confirming the diagnosis of an enostosis or bone island lesion.

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