Presentation
-painless bony swelling/mass

Examination
-consistency -bony hard
-painless- if tender ?malignant change
-around metaphyseal region
-look for compressive effects
-nerve -numbness distally
-vessels - pulses
-tendons - ROM adjacent joint
-look for other exostosis

Common Qs:
1.What is exostosis
-osteochondroma
-benign cartilage tumor arising from epiphyseal-metaphyseal region
-due to ?developmental disorder

2.How to diagnose ? need biopsy?
-clinical & radiological - typical
-biopsy - not needed

3.What are the radiological changes?
-usually pedunculated bonymass with cartilage cap
-arise from metaphysis
-has common medullary canal, cortex is continuous

4.Types?
-pedunculated
-sessile

5.Can turn malignant? what type of Ca?
-Yes, single - 1% ,multiple -10%
-Chondrosarcoma.

6.Symptoms and signs of malignant change?
-Suddenly becomes : painful , increase in size progressively, compressive effect.

7.any investigation can be done ?
-Yes, MRI - see size of cartilage cap. >2.5 cm.

8.Treatment
-small & asymptomatic - leave alone
-cosmetically not acceptable, pain or presence of compressive effects: excision.

Labels: Short cases in orthopaedics