An osteochondroma occurs near the growth plate of a bone and is benign (noncancerous). When children and young adults grow, the growth plate is the cartilage at the end of long bones that allows the bone to grow longer. Osteochondromas are the most common type of bone tumor in children and young adults. It usually affects the legs, arms, or pelvis, but can affect any bone. Depending on the size, location, and symptoms of osteochondroma, it may cause pain, swelling, deformity, or reduced movement of the affected bone or joint. Osteochondroma can be treated with observation, surgery, or medication. By preventing trauma or injury to the bones during growth, osteochondroma can be prevented.
Causes
There is no known cause for osteochondroma, but it is believed to be caused by a mutation within the growth plate cells. When some of the cells grow abnormally, they form a mass of bone and cartilage on the surface of the bone. The mass continues to grow until the growth plate closes or fuses, usually by the age of 20.
Osteochondroma can be caused by a variety of factors, including:
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Osteochondroma can run in families, especially if there is a history of multiple osteochondromas or the genetic syndrome hereditary multiple exostoses (HME).
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In men, osteochondroma is more common than in women, with a ratio of about 2:1.
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Osteochondroma usually develops between the ages of 10 and 15 during the puberty growth spurt.
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When the growth plate or bone is injured or fractured, osteochondroma can be triggered or aggravated.
Symptoms
The symptoms of osteochondroma may vary according to the size, location, and number of the tumors. Some people may have no symptoms at all, and the tumor may be discovered incidentally during an X-ray or a physical examination. Others may experience the following symptoms:
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The affected bone or joint feels painful or uncomfortable, especially after activity or pressure
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Visible or palpable swelling or lump on the bone
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An abnormal shape or curvature of the bone that affects the limb's appearance or function
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An inability to perform certain movements or activities due to a reduced range of motion or stiffness of the joint
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Compression or irritation of the nerves, resulting in numbness, tingling, or weakness of the limbs
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Reduced blood flow or swelling in the limb can be caused by vascular compression or obstruction
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The growth of one limb may be shorter or longer than the other due to a growth disturbance
Diagnosis
On the basis of the medical history, physical examination, and imaging tests, osteochondroma is diagnosed. The doctor will ask about the symptoms, the onset and duration of the symptoms, the medical history, and the family history of the patient. Furthermore, the doctor will conduct a physical examination, which will include:
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Examining the affected bone or joint for swelling, lumps, or deformities
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Feeling the tumor's size, shape, and consistency by palpating the affected bone or joint
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Checking for stiffness, pain, or range of motion in the affected bone or joint
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Assessing the nerve and vascular function of the affected limb for signs of compression or obstruction
Some imaging tests may also be ordered by the doctor, such as:
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An X-ray can provide information about the bone structure as well as the tumor's size, location, and location
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In MRI, the soft tissues and cartilage cap of the tumor are visible, and any malignant transformation can be ruled out
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A CT scan can provide cross-sectional images of the bone and tumor, as well as detect any calcification or fragmentation
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A bone scan can reveal the metabolic activity of the bone and the tumor, and detect any multiple or hidden tumors.
Treatment
There are a number of treatment options available for osteochondroma, depending on the size, location, and symptoms of the tumor, as well as the patient's age, health, and preferences.
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A tumor is monitored with regular physical examinations and imaging tests, and the growth plate is monitored until the tumor stops growing or closes. If the tumor is small, asymptomatic, or stable, and does not interfere with bone or joint function, this option is appropriate.
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The tumor and cartilage cap are removed from the bone and any defects or damage is repaired by surgery. Large, symptomatic, or progressive tumors causing pain, deformity, reduced movement, nerve compression, or malignancy may benefit from this option. A tumor can be surgically treated using a variety of techniques, including open surgery, arthroscopic surgery, or minimally invasive surgery, depending on its location and accessibility. There may be some risks associated with surgery, such as bleeding, infection, pain, or recurrence, as well as the need for a hospital stay and recovery period.
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An option for mild or moderate symptoms that don't require surgery is medication, which involves taking drugs that reduce pain, inflammation, or infection related to the tumor. Depending on the severity and type of the symptoms, medication can be administered orally, topically, or intravenously. It is important to use medicine with caution and under the supervision of a doctor in order to avoid side effects such as nausea, vomiting, diarrhea, or allergic reactions.
Prevention
Some measures can be taken to reduce the risk or severity of osteochondroma, including:
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It is important to avoid trauma or injury to the bones or growth plates, especially during puberty's growth spurt
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If you notice any swelling, lump, or deformity on your bone or joint, seek medical attention immediately
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Following the doctor's instructions and recommendations for treatment and follow-up
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To support bone health and growth, eat a balanced diet rich in calcium and vitamin D
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Exercise regularly to strengthen muscles and bones and to improve joint function
