“…Jamshidi et al described a treatment algorithm for differentiating benign tumors from OSD, including the following characteristics in favor of a benign tumor: lack of pain, progressive pain and bump, activity-independent pain, a bump size greater than 5 cm 2 at presentation, and age fewer than 10 years. 8 Our case did not meet all of the criteria for benign tumor, notably the requirement for absence of pain and age less than 10 years, suggesting complexity in differentiating osteochondroma from OSD.…”