In our case, the patient had no family history of familial mul- tiple exostoses and a whole body radiographic survey did not re- veal any other osteochondromas in other parts of the skeleton, which lead to the diagnosis of a solitary spinal osteochondroma. Lumbar solitary osteochondromas with neurological symp- toms are very rare, because the majority of the lesions grow out of the spinal canal and usually do not cause symptoms [8]. According to a recent review of literature by Bess et al., there were only 26 cases of lumbar osteochondromas among a total of 165 reported spinal osteochondromas. Only 12 cases (46%) were manifested with neurological symptoms such as radiating leg pain and reported additional two cases of their own [7]. MR imaging often reveals yellow marrow centrally (which has high signal intensity on T1-weighted images and interme- diate signal intensity on T2-weighted images) with low signal intensity cortex. The cartilage cap shows high signal intensity on T2-weighted images and intermediate to low signal inten- sity on T1-weighted images as a result of its higher water con- tent [9]. According to previous reports about osteochondromas in the long bones, MRI can reliably detect a cartilage cap as thin as 3 mm [10]. However, in our case, the thickness of the cartilage cap was 0.5 mm throughout the lesion and we could not demonstrate this on MRI. In the spinal canal, the usual thickness of the cartilage cap is very thin [9]. Sharma et al. reported 10 cases of spinal osteochondroma and they revealed that the thickness of osteochondroma was 0.5e1.75 mm in all 10 cases pathologically confirmed [11]. References [1] Dahlin DC, Unni KK. Bone tumors. 4th ed. Springfield, IL: Charles C Thomas; 1986. p. 19e22, 228e9. [2] Robbins SE, Laitt RD, Lewis T. Hereditary spinal osteochondromas in diaphyseal aclasia. Neuroradiology 1996;38:59e61. [3] Giudici MA, Moser Jr RP, Kransdorf MJ. Cartilaginous bone tumors. Radiol Clin North Am 1993;31:237e59. [4] Scarborough MR, Moreau G. Benign cartilage tumors. Orthop Clin North Am 1996;27:583e9. [5] Gille O, Pointillart V, Vital JM. Courses of spinal solitary osteochondro- mas. Spine 2004;30:13e9. [6] Barros TEP, Oliveira RP, Taricco MA, Gonzalez CH. Hereditary multiple exostoses and cervical ventral protuberance causing dysphagia. Spine 1995;20:1640e2. [7] Bess RS, Robbin MR, Bohlman HH, Thompson GH. Spinal exostoses: analysis of twelve cases and review of the literature. Spine 2005; 30:774e80. [8] Ohtori S, Yamagata M, Hanaoka E, Suzuki H, Takahashi K, Sameda H, et al. Osteochondroma in the lumbar spinal canal causing sciatic pain: report of two cases. J Orthop Sci 2003;8:112e5. [9] Murphey MD, Choi JJ, Kransdorf MJ, Flemming DJ, Cannon FH. From the archives of the AFIP. Imaging of osteochondromas: variants and com- plications with radiologicepathologic correlation. Radiographics 2000; 20:1407e34. [10] Lee JK, Yao L, Wirth CR. MR imaging of solitary osteochondromas: report of eight cases. AJR Am J Roentgenol 1987;149:557e60. [11] Sharma MC, Arora R, Deol PS, Mahapatra AK, Matha VS, Sarkar C. Osteochondroma of the spine: an enigmatic tumor of the spinal cord. A series of 10 cases. J Neurosurg Sci 2002;46:66e70. Jo Byung-June* Chung Seung-Eun Department of Diagnostic Radiology, Wooridul Spine Hospital, 47-7 Chungdam-Dong, Gangnam-Gu, Seoul 135-100, Republic of Korea *Corresponding author. Tel.: þ82 2 5138 732; fax: þ82 2 5138 175. E-mail address: jbj135@gmail.com (J. Byung-June) Lee Sang-Ho Department of Neurosurgery, Wooridul Spine Hospital, Seoul, Republic of Korea Jeon Sang Hyeop Department of Thoracic and Cardiovascular surgery, Wooridul Spine Hospital, Seoul, Republic of Korea Paeng Sung Suk Department of Pathology, Wooridul Spine Hospital, Seoul, Republic of Korea 18 November 2005 Available online 29 May 2007 1297-319X/$ - see front matter Ó 2007 Elsevier Masson SAS. All rights reserved. doi:10.1016/j.jbspin.2006.04.010 Discomfort during sexual intercourse secondary to osteochondroma: A report of two cases Keywords: Osteochondroma complications; Dyspareunia 1. Introduction Osteochondromas are rarely associated with urological complications; the literature contains only three reports of pelvic osteochondromas causing hematuria [1e3] due to compression of the bladder wall, and only one report of Fig. 3. Sagittal T1-weighted MRI shows a slightly high signal intensity mass (arrow) with peripheral low signal intensity rim. Combined disk herniation is noted ventral to this lesion. 401 Letters to the editor / Joint Bone Spine 74 (2007) 400e406