Orthopaedic Nurses Certification Board (ONCB) Metabolic/Inflammatory/Tumors Practice Exam

What is the recommended follow-up care for an isolated, asymptomatic endochondroma in the distal femur?

1. Schedule radiofrequency ablation.

2. Plan injection of high-dose steroids.

3. Follow with serial x-rays.

4. Plan surgical excision.

The correct answer is: Follow with serial x-rays.

For an isolated, asymptomatic endochondroma in the distal femur, the recommended follow-up care involves closely monitoring the condition through serial x-rays. This approach is based on the generally benign nature of endochondromas, which are cartilage-forming tumors that typically do not cause symptoms or complications in most cases. By using serial x-rays, healthcare providers can track any changes in size or appearance of the tumor over time while ensuring that it remains stable and does not progress to a more concerning condition. In many instances, endochondromas are discovered incidentally during imaging for unrelated issues, and if the patient remains asymptomatic, intervention is usually not warranted. Serial imaging allows for timely intervention if there are any signs that the endochondroma is changing in a way that may warrant more aggressive treatment, such as surgical excision, particularly if there are signs of an increase in size or associated symptoms. The other options present potential interventions that are not typically indicated for an asymptomatic endochondroma. Radiofrequency ablation and high-dose steroid injections would be more relevant in cases where there is a risk of tumor progression or if the tumor were symptomatic. Surgical excision, while a definitive treatment for tumors when indicated, is generally reserved for symptomatic lesions or those