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osteochondroma; osteocartilagenous exostosis; osteochondromatosis
Etiology:
- unknown
- does not result from injury
Epidemiology:
- develops during childhood or adolescence
- teenagers & young adults
- soliary osteochondromas represent 35-40% of benign bone tumors
Pathology:
- benign bone tumor often arise near the metaphyses of bone
- abnormal growth that forms on the surface of a bone near the growth plate
- neoplasm consist of both bone & cartilage
- growth of neoplasm generally stops with skeletal maturity
- may be single tumor (osteocartilagenous exostosis) or multiple tumors (osteochondromatosis)
- rarely cause pathological fractures
Genetics:
- associated with defects in EXT1
- see hereditary multiple exostoses
Clinical manifestations:
- generally asymptomatic
- painless lump near a joint
- knee & shoulder most often involved.
- distal femur is most common location
- pain with activity
- osteochondroma located under a tendon
- the tendon moving over an osteochondroma may result in pain
- paresthesia
- tumor may put pressure on a nerve, such as behind the knee
- changes in blood flow tumor may compress a blood vessel
Laboratory:
- bone biopsy is osteosarcoma suspected
Radiology:
- X-ray of long bones
- outgrowth may have a stalk or stem that sticks out from normal bone
- generally appear as a bone spur arising from the external surface of bone pointing away from the adjacent (knee) joint
- computed tomography
- magnetic resonance imaging
- a thick covering of cartilage over the tumor is suspicious for malignant transformation
Differential diagnosis:
- chondrosarcoma
Management:
- generally, no treatment required
Related
chondroma; enchondroma
Specific
hereditary multiple exostoses (diaphyseal aclasis)
General
chondroid neoplasm (cartilage neoplasm)
bone neoplasm
osteochondropathy (disorder of bone & cartilage)
References
- OrthoInfo: Osteochondroma
http://orthoinfo.aaos.org/topic.cfm?topic=A00079
- Wikipedia: Osteochondroma
http://en.wikipedia.org/wiki/Osteochondroma
- The Children's Hospital of Philadelphia: Osteochondroma
http://www.chop.edu/service/orthopaedic-surgery/spine-conditions-we-treat/benign-musculoskeletal-tumors/osteochondroma.html
- Errani C, Tsukamoto S, Mavrogenis AF.
Imaging Analyses of Bone Tumors.
JBJS Rev. 2020 Mar;8(3):e0077.
PMID: 32149935 Review.