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Answer: Macrodystrophia lipomatosa

Findings:

• Radiograph: 2nd digit demonstrates soft tissue and osseous overgrowth, lateral bowing, premature osteoarthritis, cortical thickening
  
  
• Axial T1 MRI: Overgrowth of the 2nd digit with increased soft tissue fat deposition surrounding the 1st and 2nd digits (yellow arrow), thickened plantar nerve with increased fibroadipose tissue producing a "coaxial cable" appearance (red arrow)
  
  

Question: The next step in management is:

• No further management necessary
• Observation
• Biopsy
• Surgery

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