Enchondroma

This patient presented with acute onset foot pain. Radiographs of the foot were obtained which demonstrates a lytic, expansile lesion in the proximal phalanx of the small toe. Additionally, there is a superimposed cortical disruption of the proximal phalanx as indicated by the red arrow secondary to pathologic fracture. On close inspection, there are a couple small foci of calcification within the lesion consistent with a chondroid matrix. The imaging features of this lesion are most consistent with an enchondroma with pathologic fracture. Enchondromas are benign cartilaginous tumors which often occur in the hands and foot. Even without pathologic fracture, they may be cause of pain in an extremity.