What Is an Osteochondroma?

Osteochondroma is a common benign bone tumor in childhood. It is usually located on the cortex of one side of the metaphysis and grows to the surface of the bone. It is also called exostosis. The disease can be divided into single and multiple, the latter has a genetic predisposition and affects the development of epiphyseal or limb deformities, known as multiple hereditary osteochondroma disease, or continuation of the backbone. The lesion is located at the metaphysis. Distal femur, proximal tibia and proximal humerus are most common. Clinically, osteochondroma has no pain or tenderness, and produces corresponding symptoms when the nerve is compressed.

Basic Information

Also known as

Exoskeleton warts

English name

osteochondromatosis

Visiting department

orthopedics

Common symptoms

tenderness

Contagious

no

Causes of osteochondroma

Osteochondroma is not a tumor in the strict sense. It is an abnormal growth or hamartoma. The tumor has a cartilage cap and a bone tissue protruding from the side of the bone. This disease, also called bone wart, may be caused by small cartilage islands near the periosteum, or from the epiphyseal cartilage. All cartilage ossification sites can occur. Long tubular bones in the lower limbs account for 1/2, and the lower end of femur and upper end of tibia are the most. Followed by the upper end of the humerus, the lower end of the radius and tibia, and the ends of the fibula. The lesion is located at the metaphysis. With the growth and development gradually away from the epiphyseal plate. The bone marrow in bone warts is rich in adipose tissue. The growth of bone warts is due to the cartilage ossification of the cartilage cap. When the child matures, the bone warts stop growing. In adulthood, the cartilage cap gradually degenerates and even disappears. It sometimes persists and can be secondary to chondrosarcoma.

Clinical manifestations of osteochondroma

Osteochondroma can grow on any bone with cartilage, and long tubular bones are more common than flat bones and short bones. Distal femur, proximal tibia and proximal humerus are most common. The tumor does not cause pain, and it is often found by accidental mass or X-ray examination. There is often no tenderness in some areas, and some of them produce corresponding symptoms due to compression of vascular nerves and internal organs. The medial bone warts at the lower end of the femur or the upper end of the tibia can have a tendon sliding sensation. Pain is not felt until the mass is directly impacted or the pedicle is broken. When the tumor is larger, it can compress the nerve. Lumbar vertebrae can cause compression of the cauda equina. Foot and ankle masses can make walking and shoes difficult, and some can be accompanied by bursitis or bursitis.

Osteochondroma examination

The X-ray of osteochondroma shows that the bony lesions protrude from the metaphysis. Because the cartilage cap and bursa are not developed, the bone image of the tumor is exactly the same as the bone structure of the metaphysis at the site. Tumors in long bones grow in the same direction as the adjacent muscles. Osteochondroma in the distal femur grows toward the femur. Tumors in the proximal tibia grow in the distal tibia. They have different shapes and may have a long pedicle and narrow The basal, or very short, broad basal, larger tumors have swelled apex like cauliflower.

Osteochondroma diagnosis

Diagnosis can be made based on medical history, clinical manifestations, and X-ray findings.

Osteochondroma complications

Osteochondroma can be associated with limb flexion and shortening deformities, and occasionally secondary to chondrosarcoma.

Osteochondroma treatment

The only effective treatment for osteochondroma is surgical resection. In the past, it was considered that the tumor would stop growing with the diaphragm closed, and the malignant rate was extremely low (single-onset 0.5% to 1%, multiple onset about 2%), local pain, joint movement or compression of blood vessels, Nerves and organs are indications for surgical resection.

At present, it is advocated that once a single osteochondroma is diagnosed, it should be surgically removed. Multiple osteochondroma has a large number of lesions, which is difficult to remove in one operation. It is difficult to accept patients with several or dozens of operations to remove tumors. They can only selectively remove osteochondrals that are symptomatic or hinder joint movements and accompany limb deformities tumor. Orthopedic surgery of limb deformity can be based on its complexity and can be completed in one stage with tumor resection or in stages. Tumors that compress nerves, blood vessels, or affect joint activity, and fractures of the pedicle trauma have indications for surgical resection.

The focus of the operation is to remove the periosteal membrane from the base without removing the partially covered periosteum. The cartilage cap and the periosteum must be removed at the same time to prevent tumor recurrence and prevent damage to the diaphragm.

Osteochondroma prevention

Osteochondroma will stop growing as the epiphyseal plate is closed, and the malignant rate is extremely low (single-onset is 0.5% to 1%, multiple is about 2%), less than 1% of those with malignant changes, and turned into chondrosarcoma , Osteosarcoma or fibrosarcoma are rare.