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consulta por tumoraci&#243;n en la segunda falange del tercer dedo de la mano izquierda de meses de evoluci&#243;n &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>A y B&#41;&#46; Dada la rareza de un tofo gotoso en dicha localizaci&#243;n&#44; se realiz&#243; radiograf&#237;a simple &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>C y D&#41;&#44; objetiv&#225;ndose una lesi&#243;n l&#237;tica expansiva&#46; Posteriormente&#44; se solicit&#243; resonancia magn&#233;tica nuclear &#40;RMN&#41;&#44; cuyos hallazgos eran sugestivos de malignidad &#40;<a class="elsevierStyleCrossRef" href="#fig0010">fig&#46; 2</a>A-C&#41;&#46; Finalmente&#44; se realiz&#243; biopsia&#44; siendo diagn&#243;stica de encondroma &#40;<a class="elsevierStyleCrossRef" href="#fig0010">fig&#46; 2</a>D&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">El diagn&#243;stico diferencial de una lesi&#243;n en la mano como la que presentamos incluye&#44; adem&#225;s del tofo gotoso intra&#243;seo &#40;descrito hasta en el 13&#44;3&#37; en artropat&#237;a &#250;rica evolucionada&#41;<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">5&#44;6</span></a> y del encondroma&#44; otros tumores &#243;seos como el condrosarcoma<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a>&#44; el condroblastoma de bajo grado&#44; el fibroma mixoide&#44; los quistes epidermoides&#44; los fibromas no osificantes&#44; la displasia fibrosa y el tumor de c&#233;lulas gigantes<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a>&#46; Otras entidades a descartar ser&#237;an los infartos &#243;seos&#44; los tumores pardos del hiperparatiroidismo<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a>&#44; los xantomas&#44; los n&#243;dulos reumatoides y los granulomas sarcoideos<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> o los relacionados con infecciones &#40;s&#237;filis&#44; <span class="elsevierStyleItalic">Borrelia</span>&#44; micobacterias&#41;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a>&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">En la radiograf&#237;a&#44; los encondromas se observan como lesiones redondeadas bien definidas con radiolucidez central en la di&#225;fisis o la met&#225;fisis&#46; Pueden tener contorno lobulado&#44; calcificaciones puntiformes e incluso festoneado del endostio&#44; adelgazamiento cortical y fracturas patol&#243;gicas cuando hay expansi&#243;n importante<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a>&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Responsabilidades &#233;ticas</span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Protecci&#243;n de personas y animales</span><p id="par0025" class="elsevierStylePara elsevierViewall">Los autores declaran que para esta investigaci&#243;n no se han realizado experimentos en seres humanos ni en animales&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Confidencialidad de los datos</span><p id="par0030" class="elsevierStylePara elsevierViewall">Los autores declaran que en este art&#237;culo no aparecen datos de pacientes&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Derecho a la privacidad y consentimiento informado</span><p id="par0035" class="elsevierStylePara elsevierViewall">Los autores declaran que en este art&#237;culo no aparecen datos de pacientes&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflicto de intereses</span><p id="par0040" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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          "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A y B&#41; Tumoraci&#243;n multilobulada en la segunda falange del tercer dedo de la mano izquierda&#46; C y D&#41; Radiograf&#237;a PA y lateral del tercer dedo de la mano izquierda&#59; se visualiza una lesi&#243;n l&#237;tica expansiva de gran tama&#241;o&#44; que insufla&#44; adelgaza y destruye la cortical&#46;</p>"
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          "es" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A-C&#41; Im&#225;genes de RMN&#59; lesi&#243;n expansiva multilobulada que muestra festoneado end&#243;stico y adelgazamiento cortical importante&#44; hipointensa en T1 &#40;corte axial&#41; e hiperintensa en secuencia potenciada en T2 con supresi&#243;n grasa &#40;corte sagital&#41; y en secuencia STIR &#40;corte coronal&#41;&#46; D&#41; Biopsia de la tumoraci&#243;n en la que se visualiza cart&#237;lago maduro hialino &#40;flechas&#41;&#44; con &#225;reas de degeneraci&#243;n mixoide &#40;cabezas de flechas&#41;&#44; compatible con encondroma&#46;</p>"
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