Radiological Case

Rib Osteochondromas Mimicking Lung Nodules

Gali Shapira-Zaltsberg, MD; Carmen Rotaru, MD


Appl Radiol. 2021;50(1):56a-56b. 

In This Article


Osteochondromas, or exostoses, are benign, cartilage-capped bone tumors with continuous cortex and marrow extending from the underlying bone. Osteochondromas may be solitary or multiple. When multiple, these lesions are associated with the autosomal dominant syndrome, hereditary multiple exostoses (HME).[1] Patients with HME typically present with osteochondromas of the costal bones (40%), proximal humerus (50%), distal femur (70%), and proximal tibia (70%).[2] Complications associated with osteochondromas are more frequent with HME; they include deformity (cosmetic and osseous), fracture, vascular compromise, neurologic sequelae, overlying bursa formation, and malignant transformation.[1]

Several case reports have described costal osteochondromas as a cause for thoracic injury, including hemothorax and pneumothorax.[3–6] Chronic pleural effusion[7,8] and pleuritic chest pain[9] secondary to chondral osteochondromas have also been reported.