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Case Reports in Medicine
Volume 2012 (2012), Article ID 453560, 9 pages
http://dx.doi.org/10.1155/2012/453560
Case Report

Bizarre Parosteal Osteochondromatous Proliferation (Nora’s Lesion) of the Hand: A Report of Two Atypical Cases

1Orthopaedic Surgery and Traumatology Department, Hospital Universitari Vall d’Hebron, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain
2Hand Surgery Unit, Orthopaedic Surgery and Traumatology Department, Hospital Universitari Vall d’Hebron, Spain
3Hand Surgery, Institut Kaplan, Passeig de la Bonanova 9, 2n Pis, 2a Porta, 08022 Barcelona, Spain
4Orthopaedic Oncology Unit, Orthopaedic Surgery and Traumatology Department, Hospital Universitari Vall d’Hebron, Spain

Received 20 October 2012; Accepted 16 December 2012

Academic Editor: Mamede de Carvalho

Copyright © 2012 Sergi Barrera-Ochoa et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Bizarre parosteal osteochondromatous proliferation (BPOP), also called Nora’s lesion, is an unusual, benign, bony lesion frequently found in the hand. Originally, two of the key radiological features used to describe such lesions were: (1) a lack of corticomedullar continuity and (2) an origin from the periosteal aspect of an intact cortex. The authors present 2 unique cases of histologically proven BPOP in which the integrity of the cortex was affected. In the first case there was medullary continuity, and in the second case there was saucerization of the underlying cortical bone. The authors support that simple X-ray evaluation is insufficient to diagnose BPOP in atypical cases. Careful axial CT scanning or MRI may prove helpful. Taking into account these new notions, histopathology gains greater importance as a diagnostic tool for this particular group of entities.