A 13-year-old girl presented with pain and swelling on the medial aspect of the proximal leg, which she had noticed for several years. Her height and body weight were 161 cm and 64 kg, respectively. She had no past medical history related to the lesion. There was no history of trauma or injury. On physical examination, the non-mobile hard lesion was palpable with slight tenderness on the medial side of the proximal tibia. Plain radiographs showed a lesion protruding from the bone with continuity to the underlying bone (Fig. ). The size of the lesion was 2.0 cm on a plain radiograph. MRI depicted a protuberant bone lesion with continuity to normal bone. However, an overlying cartilaginous cap or surrounding inflammation was not apparent (Figs. ). Surgically, the lesions were approached posterior to the conjoint tendon, and resected using a curved chisel (Fig. ). The lesion was composed of lamellar bone trabeculae with fatty marrow and a covering cartilaginous component, compatible with osteochondroma. There was no evidence of malignancy. Six months after surgery, the preoperative symptoms had disappeared.
Another 13-year-old male child presented to the outpatient department with similar complaints of knee pain on the left side for the last two months. The onset was insidious and there was no history of trauma. There was no history of swelling or pain in any other part of the body. On examination, it was found that tenderness was present at the medial aspect of left proximal tibia. No swelling was palpable. Rest of the local examination and systemic examination were unremarkable. Plain radiographs of the left knee revealed a sharp bony spur arising from proximal tibial metaphysis, similar to the first case (Figure ). But the radiograph of the contra-lateral knee was unremarkable. The patient was again advised rest and analgesic medications for three weeks. No other subsequent intervention was required, and at the last follow-up of two years, there was no recurrence of pain.