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A hard lump on a child’s shin
  1. Phillip Ross1,
  2. Jonathan Henderson1,
  3. Rachel Martin2,
  4. Shilpa Shah1
  1. 1 Paediatrics, Southern Health and Social Care Trust, Portadown, UK
  2. 2 Radiology, Southern Health and Social Care Trust, Portadown, UK
  1. Correspondence to Dr Shilpa Shah, Paediatrics, Southern Health and Social Care Trust, Portadown BT63 5QQ, UK; drshilparshah{at}

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A 16-month-old boy presents to the emergency department referred by his general practitioner with a painless lump on his right leg gradually increasing in size over the last 3 weeks. There is no associated trauma, no similar swellings elsewhere, and no weight loss, night sweats, fever or ill health. Although not walking independently, he can bear weight on his legs, stand with support and cruise. His fine motor and sociocommunicative milestones are age-appropriate. Examination reveals a 1.5 cm hard, painless, spherical lesion with smooth surface, non-mobile and likely adherent to the underlying bone. Its location is over the mid-shaft of the right tibia. Systemic examination is normal.

He had an anteroposterior and lateral X-ray of the tibia and fibula showing a radio-opaque nodule overlying the right tibia anteriorly and separate from the underlying bone with no …

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  • Contributors Original artwork by PR.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.