Osteochondroma of the iliac crest as a mimicker of prolapsed intervertebral disc- A case report and review of literature

Abstract

Osteochondromas of the pelvis are benign bone tumors. They might be accidently discovered during imaging studies and can stay inactive without causing any symptoms. However, as they grow larger, they may cause compressive symptoms in adjacent areas. A 17-year-old male presented with a history of back strain sustained while participating in sports. He experienced shooting pain radiating down his left leg, following the L4 dermatome pattern. Nerve irritation tests, such as the straight leg raise test and reported paresthesia in the L4 dermatome, were positive. The classic symptoms and clinical findings lead to an initial tentative diagnosis of a prolapsed intervertebral disc with no “red flags” symptoms. He was prescribed conservative treatment. However, there was no alleviation of pain over the next six weeks, at which point an MRI (Magnetic Resonance Imaging) identified an osteochondroma of Iliac crest. Following the excision of the lesion, the patient made a complete recovery without recurrence of lesion. Osteochondromas continue to perplex healthcare professionals as they can arise in isolated form at various location of bones. Pelvic osteochondroma leading to radicular symptom is very unusual. The primary treatment approach for symptomatic cases are to surgically remove the lesion.