Differentiating clinical and radiographic features of XXXX in the foot.

@entity1 @entity2835 @entity511 @entity174 @entity3478 @entity5 @entity83 @entity1345
BACKGROUND: Enchondroma is the most common @entity5 of the bones of the foot. @entity511 in this area is relatively rare with @entity5 occurring rarely. In contrast to similar @entity5 in the appendicular skeleton, it is difficult to distinguish between these two @entity5 when they occur in the foot. METHODS: We reviewed the medical records and radiographs of all @entity1 with @entity83 and @entity511 arising from @entity83 (secondary @entity511 ) from the radiologic archives at the @entity1345 ( @entity1345 ) and identified those @entity1 with @entity5 involving the bones of the foot. There were 755 @entity1 with @entity83 of which 34 (4.8%) involved the foot; there were 340 @entity1 with secondary @entity511 and 14 (4.1%) involved the foot. We compared clinical and radiographic features of both these lesions. We also compared interobserver differences not only for diagnosis but also for the presence of scalloping, @entity174 , @entity2835 , and mineralized matrix. RESULTS: Size and location were statistically significant variables differentiating the two @entity5 (p = 0.03). @entity83 had a mean size of 2.7 cm(2). Lesions that occurred in the hindfoot and midfoot were more likely to be malignant compared to those in the forefoot. In comparing interobserver reliability, most disagreement occurred regarding the presence or absence of matrix with the examiners concurring only 51% of the time. With regard to diagnosis, the examiners' accuracy was 71% and 80%. Their accuracy increased only to 83% when they agreed. CONCLUSION: Our findings suggest that it is difficult to differentiate @entity83 in the foot. Concern for malignant change is warranted for cartilage @entity3478 of the foot if they exceed 5 cm(2), or if they arise in the midfoot or hindfoot. In these cases, we recommend either biopsy or close clinical followup.
