Osteochondroma of the posterior femoral neck: A rare cause of Sciatic Nerve Compression

Sanjay Yadav; Pankaj Maurya; Mohit Kumar; Rajkumar Arya

Volume : VII, Issue : X, October - 2018

Osteochondroma of the posterior femoral neck: A rare cause of Sciatic Nerve Compression

Sanjay Yadav, Pankaj Maurya, Mohit Kumar, Rajkumar Arya

Abstract :

Introduction: Osteochondroma is the most common primary benign bone tumor and comprises a third of these tumors. They are usually extraarticular secondary to their common origin from metaphysis of long bones. Osteochondroma of the femoral neck is atypical as they represent an intraarticular lesion. They are mostly asymptomatic depending on their size and location.

Case study: An eighteen year old male presented to us with complaint of pain in left posterior hip region, difficulty in sitting on hard surface, mass in buttock associated with tingling sensations in left lower limb since eight months. On examination, sensations were decreased on plantar and dorsal aspect of left foot. Motor power was diminished for both ankle plantar and dorsiflexors. A firm to hard pedunculated mass measuring 12 x 10 cm was palpated on posterior femoral neck which was confirmed on plain radiographs. CT and MRI were done to further delineate the anatomy and cartilage cap assessment.

Management: Surgical intervention in the form of extra-periosteal resection was performed through posterior approach. Intra-operatively, sciatic nerve was found to be stretched on medial aspect of tumor. Post-operatively symptoms resolved dramatically. At follow up, patient had full resolution of neurologic findings. Histopathology report confirmed the diagnosis of osteochondroma.

Conclusion: one should be aware of rare entities such as proximal femur osteochondroma during diagnosis and treatment of sciatic neuropathy along with other common etiologies.