For almost two centuries, the behavior of bone formation has been studied, the appearance and progression of which people are not always aware of. It is unknown how common the pathology is among the population, because in most cases it occurs latently and asymptomatically. Medicine has a large arsenal of surgical treatment methods, but so far no unified tactics have been developed. Exostosis disease occurs in children, adolescents and young adults aged 8-20 years during puberty. There are no data on the incidence of children under 6 years of age.

What is exostosis

Single or multiple benign neoplasms arising on the surface of the bone from gradually hardening cartilage tissue, has two names - bone exostosis or osteochondroma. This tumor is from 10 mm to 10 cm in size and has a spherical, spinous, mushroom-shaped, linear shape. The epiphyseal plate, which is responsible for the growth of skeletal tissue in adolescence, is located at the ends of the long tubular bones limbs, is the platform from which the formation of osteochondroma begins.

Exostotic disease is a common primary defect, accounting for 10-12% of all types of bone tumors and 50% of benign formations. On initial stage development, it is cartilage, reminiscent of articular, and over time it turns into spongy bone, framed by a cartilaginous shell up to 1 cm thick. The covering of cartilage tissue constantly grows and hardens, increasing the size of the tumor. The formation is persistent, but facts have been noted when it gradually smoothed out and disappeared forever.

Reasons for the formation of exostosis

The etiology of the tumor is not always determined by doctors. It is known that a single compaction occurs as a result of increased growth of cartilage tissue caused by a number of reasons, and multiple neoplasms are inherited, family diseases. There are a number external factors, contributing to the formation of spongy growth:

• chronic inflammatory diseases bone or cartilage tissue;
• intensive tissue growth at the sites of injuries, fractures, bruises, and skeletal injuries;
• infectious diseases;
• abnormalities in the development of periosteum and cartilage;
• excess calcium in the body, stimulating the development of bone tissue;
• increased skeletal growth during puberty in adolescents;
• disruption of the endocrine system.

Symptoms of exostosis

Signs of pathology depend on its location and size. It is sometimes difficult to detect a neoplasm, because for a long time its formation is asymptomatic - slow and painless. As a rule, a lump is discovered by chance when it begins to be palpated and becomes noticeable upon examination. Pain syndrome occurs when the growth increases to a certain size.

When the tumor is large, compression of the blood vessels and nerves occurs, causing pain syndrome during movement, physical stress, pressure on the bone, and as the compaction grows, the pain intensifies. At this stage it is also possible headache and dizziness, numbness in parts of the body, and a sensation of goosebumps on the skin. The pathology is accompanied by a pain syndrome during degeneration into malignant tumor. Exostosis is characterized by severe pain knee joint, destruction or peeling of the nail under the influence of a growing growth, etc.

Forms and localization of exostoses

Osteochondral pathologies can be divided into solitary (single) and multiple. Both types of formations have various reasons occurrence, cause various complications, affect different age categories people:

• solitary osteochondral exostosis is a single immobile growth that, as it grows, compresses nearby nerve trunks and vessels, causing severe pain. The disease is acquired and is the result of injuries, infectious and inflammatory processes in the body. For example, after a hip fracture with high probability exostosis develops femur. In 70% of cases, the defect occurs in patients under 30 years of age. In adolescents, the process progresses during rapid growth bone tissue and stops upon completion of the formation of the skeleton;
• multiple exostotic chondrodysplasia - several located in different places growths that, as they grow, touch the adjacent bone, damage and deform joints. Such neoplasms are diseases that are inherited according to an autosomal dominant type of inheritance, in which only one defective gene is enough for the development of pathology. The tumor occurs more often in patients under 20 years of age.

Initially, the defect is located on the metaphysis - the rounded, expanded end section of the tubular bone of the limb. As the skeleton grows, it moves towards the diaphysis - central department long bone. The defect grows away from the articulation of the bones, but there are known facts of growth in the opposite direction, which leads to disruption of the functionality of the joint.

The location of the tumor is often the pelvic, tibia and femur bones, forearm, collarbone, scapula, ribs, vertebrae, knee joints. Exostosis of the calcaneus, knee joint, and spine is common. The growth rarely appears on the phalanges of the fingers and toes; cases of tumor occurrence on the skull are unknown. Marginal exostoses are formed at the bone ends.

Diagnostics

Detection of pathology often occurs unexpectedly, when touching a place where discomfort is felt. Another accident is the reflection of the tumor on x-ray performed in connection with another disease. Often the reason for diagnostic procedures The patient complains of pain in the joints and spine, accompanied by dizziness, numbness in parts of the body, etc. An X-ray examination is mandatory in any case - in the absence of pain and in its presence.

If there is a sudden increase in tumor growth, an increase in its diameter by more than 5 cm, and the thickness of the cartilage coating by more than 1 cm, an urgent x-ray is required. Suspicion of malignancy arises from the outline irregular shape with fuzzy edges. Sometimes the tumor appears mottled and the bone around the lesion is swollen. To clarify the diagnosis, a biopsy is performed based on material taken from several areas. Sometimes an MRI or computed tomography.

The image clearly shows that the contours of the underlying cancellous bone of the neoplasm merge. The cartilaginous cap is not visible, but the foci of calcification present in it are recognized. When microscopy of the cartilage covering, randomly located chondrocytes are clearly visible - tissue cells of different sizes. In older people, the cartilaginous cap may be absent. The thickness of the shell should be no more than 1 cm; for larger values, it is necessary to check for the presence of secondary, malignant chondrosarcoma.

Treatment of exostosis

In most precedents, the pathological focus behaves calmly - after the age of 20, it does not change in size, does not cause pain, and does not limit the functionality of parts of the skeleton. In this case, treatment of the defect is not required, only observation is carried out. If pain occurs, the tumor quickly grows, severe bone deformation develops at the site of the tumor, discomfort is felt, it is excised with complete removal cartilaginous cap and scraping the periosteum adjacent to it using a medical chisel.

If it is necessary to remove the growth along with the root, a bone defect may form, which must be filled with a graft. In this place, the bone structure will be restored only after 2 years. More preferable are preservation operations, during which the formation is fractured at the site of transition into the maternal bone and removed as a single block. Using a cutter, the surface of the mother bone is processed without removing the root of the growth from it.

Today we offer an article on the topic: “Osteochondral exostoses: treatment, symptoms, causes, prevention.” We tried to describe everything clearly and in detail. If you have any questions, ask at the end of the article.

Very often, especially in childhood, one has to hear terrible diagnosis– exostosis. What kind of disease is this, and is it so dangerous?

This osteochondral or bone growth of non-tumor nature on the surface of the bone. At first, the neoplasm consists only of cartilage tissue, but over time it hardens and transforms into spongy bone.

A cartilaginous coating several millimeters thick remains on top. This serves as the basis for further growth of the tumor.

The main danger of the disease is that it develops very slowly and is asymptomatic. The size of the growths can range from a few millimeters to ten or more centimeters.

Another feature of exostosis is that it is usually diagnosed in adolescence when intensive skeletal growth occurs. There is also a theory about a hereditary predisposition to the disease, but it has not been confirmed.

It could be:

• bruise or pinching;
• dysfunction of the endocrine system;
• abnormalities in the development of cartilage and periosteum;
• inflammatory process;
• some infectious diseases (for example, syphilis).

  The photo shows exostosis of the calcaneus

Today large number Research is aimed at studying the heredity of this disease.

However, despite the fact that many cases of familial exostoses are known, most scientists are skeptical about this theory. After all, it does not explain isolated cases of the disease, which means it cannot be the only true one.

At the same time, there are certain risk factors that influence the development of the disease. The main one is excess calcium in the body.

When deposited on the bones, this element eventually leads to the formation of growths. Hypercalcemia can occur due to excess consumption of eggs, dairy products, cabbage, parsley, or hard water.

Features of osteochondral growth

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Osteochondral exostosis, or osteochondroma, is a benign bone tumor formed from cartilage tissue.

The disease, as a rule, does not manifest itself until the age of 8, but during the period of active skeletal growth - from 8 to 17 years - the likelihood of its development increases several times. Most often it is diagnosed in adolescents during puberty.

With osteochondroma, the number of growths can vary from a few to dozens.

Based on this criterion, the disease is divided into two types:

1. Solitary osteochondral exostosis. Always represented by one tumor. It comes in different sizes and is immovable. If the tumor increases significantly, it can put pressure on blood vessels and nerve trunks;
2. Multiple exostotic chondrodysplasia. This type of disease is characterized by the appearance of several neoplasms at once. It is chondrodysplasia that is most often inherited.

Classification and localization

In most cases, exostosis is diagnosed on shoulder joint, hip bone, collarbone, scapula, more tibia.

According to statistics, 50% of all exostoses occur on the tibia and femur. Much less often the disease affects the hands and feet. Also, medicine does not know cases of the formation of growths on the skull.

If the disease affects the spine, then with its further development compression may occur spinal cord.

This localization is dangerous because it leads to serious disruptions in the functioning of the central nervous system, and is also most prone to malignant degeneration.

Symptoms and diagnosis

The disease develops very slowly and is usually asymptomatic. It may take years before the disease is identified. The only exceptions are cases when growths put pressure on blood vessels or nerve endings.

Then there may be pain in the area of ​​compression, a feeling of numbness or goosebumps, headaches, and dizziness.

Most often, the disease is detected accidentally during an X-ray examination. Without x-rays, diagnosis is almost impossible.

Carrying out this type of research allows us to say about the number and shape of neoplasms, their size and development. At the same time, it must be taken into account that the cartilage plaque that covers the growth is not visible in the image.

Therefore, the actual size of the tumor is always larger than it appears.

Removing growths

Methods conservative treatment the disease does not exist. If necessary, overgrown areas of bone tissue are removed during surgery.

Children under 18 years of age are not subject to surgery due to the fact that exostoses may resolve on their own.

The operation is carried out:

• if on the face rapid growth fabrics;
• if the tumor is so large that it stands out on the surface;
• if the growths compress blood vessels or nerves.

Surgical treatment is performed under local or general anesthesia depending on the location and size of the tumor. First, the bone growth is removed using a chisel, and then the bone is smoothed using special tools.

In the video, removal of exostosis of the auditory canal:

Recovery after surgery

Rehabilitation takes no more than two weeks. If only one tumor was removed, the patient can get out of bed the very next day.

Recovery after surgery is divided into two stages. At the first stage, a gentle motor mode is established. Then, when the swelling decreases, it is prescribed recovery mode. In the postoperative period, it is very important to restore the muscles to their strength.

It is necessary to achieve a state where training exercises do not cause pain. Only then is the restoration considered successful.

Complications of the disease

In most cases, exostosis does not pose a great danger, but sometimes complications of the disease occur. You should worry if growths form in the spine area.

Then, with intensive growth, they can compress the spinal cord, which leads to serious consequences.

In children and adolescents with the development of multiple chondrodysplasia, skeletal deformities are likely. Sometimes, although quite rarely, a pathology such as a fracture of the exostosis leg is diagnosed.

If tumors begin to grow quickly, there is a possibility of their malignant degeneration.

As a rule, cancerous tumors are formed on the hip, vertebrae, shoulder blade, pelvis. They may have the morphological structure of spindle cell sarcoma, chondrosarcoma and other types.

Preventive measures

Currently there is no specific system preventive measures for this disease.

The only way to prevent growths is regular inspection and examination. Such prevention is especially important for children, since bone growths in them can cause skeletal deformation.

In addition, it is always necessary to undergo a preventive examination after an injury. Any bruise, damage to nails or broken bones can cause the development of the disease.

It is also a good idea to keep under control information about the amount of calcium in the body, since its excess also leads to the formation of growths on the bones.

Instead of output

Whatever the reason for the development of exostosis, you should not be afraid of it. In fact, the disease is not as terrible as it might seem at first.

Yes, in some cases, when the tumor grows rapidly, it can indeed degenerate into malignant. However, this happens quite rarely.

In most cases, the prognosis for life with this disease is favorable. Bone growths are successfully removed in any clinic without any consequences. And sometimes the disease even resolves on its own.

This happens in children when the disease goes away spontaneously. Therefore, there is no need to panic. Believe in the best - and the disease will definitely recede.

Exostosis - bone benign growth , May be various shapes, is formed from cartilaginous tissue, after which it ossifies and becomes covered thin layer bone shell. Bone exostosis can be either single or multiple with the formation of up to several dozen growths, most often symmetrically. Development exostosis occurs slowly and develops along with the development of the skeleton, which can lead to deformations and subsequent pathologies in development, especially with multiple exostosis in children.

Causes of exostosis

Causes of cartilaginous (bone) exostosis often injuries and associated inflammatory processes. Bone exostosis is predominantly a childhood disease; the disease is often transmitted as a hereditary pathology. The size of the growths varies from a few millimeters to ten, and sometimes more, centimeters. Since the symptoms may not appear sufficiently for a long time exostosis can develop over years or even decades.

Symptoms of exostosis

Symptoms of bone exostosis most often do not appear due to the slow development of the disease. In the presence of multiple exostosis, skeletal deformities are possible due to the disorder bone growth. If exostosis develops quickly, then it is likely that it can acquire a malignant form. Exostosis can be detected mainly by chance during a routine X-ray examination or when a lump is detected under the skin during palpation.

Diagnosis of exostosis

At initial examination can only be identified suspected bone exostosis so as to give a clear picture this method not capable. An accurate diagnosis is possible only after an X-ray examination, the results of which determine the number of exostoses, the location and size of bone growths, the latter is relative, since the cartilaginous cap of the exostosis (cartilaginous outer shell) is not visible in the image, and its thickness, especially in children can reach 8-10 mm.

Treatment of exostosis

For the treatment of bone exostosis Only surgical intervention is used, during which the growth is removed from the surface of the bone. Indications for surgery are a rapid increase in exostosis in size, painful sensations or discomfort or when the growth appears visually. The operation can be performed through a small incision (10-20 mm), using local anesthesia, and the patient can leave the hospital on the day of the operation.

There are cases when exostosis disappears on its own, but such cases are quite rare.

Prevention of exostosis

The only prevention of bone exostosis is a periodic preventive examination, especially for children in whom bone exostosis can cause abnormal development bone skeleton. If you accidentally discover unnatural growths or lumps on your child, consult a doctor immediately.

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Exostosis is a benign growth on the surface of the bone. It is formed from gradually ossifying cartilaginous tissue. Exostoses can be single or multiple, have the shape of a thorn, a mushroom, a hemisphere, or even a cauliflower. Often the disease is hereditary.

Signs

Exostosis is a painless disease and may not manifest itself for a long time. And it is most often discovered by chance, for example, during radiography. But quite often it happens that exostosis can be felt. There are cases when exostosis grew to such a size that it was visible even to the naked eye.

Description

Typically, exostosis develops between the ages of 8 and 18 years. This disease appears especially often during puberty. It practically never occurs in children under 6 years of age.

Most often, exostoses appear in the upper third of the tibia, the lower third of the femur, the upper part of the fibula, the upper end of the shoulder and the lower end of the forearm bones. They can form on the scapula, collarbone, ribs, and quite rarely they can be found on the bones of the metatarsus and hand, and on the vertebrae. Exostoses do not form on the bones of the skull.

These formations may be various sizes- both the size of a pea and the size of a large apple. There are cases where exostosis was the size of a child's head.

Their number can also vary from one to several tens and even hundreds.

Reasons for the formation of exostosis:

• inflammation;
• fracture;
• injury;
• infringement;
• infections (syphilis);
• abnormalities of the periosteum or cartilage;
• some endocrine diseases.

There are two types of osteochondral exostoses: multiple exostotic chondrodysplasia and solitary osteochondral exostosis.

Do not think that if exostosis does not deliver discomfort, then it is safe. This disease has serious complications. The growth may be squeezing neighboring organs, causing their deformation and dysfunction. It can even deform bones. One more thing dangerous complication- This is a fracture of the exostosis leg. However, the most dangerous complication is the degeneration of exostosis into a malignant tumor. This occurs in approximately 1% of cases. Exostoses on the shoulder blades, femurs, pelvis, and vertebrae are most prone to this.

Diagnostics

The diagnosis is made based on the results of an x-ray examination. However, the outer cartilaginous layer of the exostosis is not visible on the x-ray, so it should be remembered that the size of the actual exostosis is larger than the study results would suggest. This is especially true for children, in whom the size of the cartilage layer can reach 8 mm.

It is necessary to differentiate this disease from bone tumors.

Treatment

Treatment of exostosis is only surgical. It is performed by an orthopedic traumatologist under local or general anesthesia. The choice of anesthesia depends on the size of the exostosis and its location. During the operation, the growth on the bone is removed, and its surface is smoothed.

The operation is now performed through a small incision. Often, if the exostosis was minor and the anesthesia was local, the patient can leave the hospital on the same day.

The prognosis is good. Usually, after removal of exostosis, a lasting recovery occurs.

Prevention

The only prevention of exostosis is regular examination and preventive examination. It is especially important to carry it out among children, since the formation of exostosis can cause improper development of the skeleton and will cause a lot of trouble in the future.

© Dr. Peter

Often, when visiting a doctor, patients hear a diagnosis that is not entirely clear - exostosis. What is it? How serious can such a disease be? What are the reasons for its occurrence? These questions interest many people who are faced with a similar problem.

Exostosis - what is it?

Exostosis is nothing more than a growth on the surface of the bone. By the way, such neoplasms can have different sizes and shapes. For example, there are growths in the shape of a mushroom or cauliflower. Bone exostosis consists of compact spongy tissue.

In some cases, the growths are formed from cartilage. Although, it is worth noting that the term “cartilaginous exostosis” is a bit of a misnomer. Yes, the neoplasm arises from cartilaginous elements, but then ossifies, turning into spongy tissue. And its surface is covered with hyaline cartilage, which, in fact, is the growth zone.

Exostosis and the reasons for its formation

In fact, the reasons for the formation of such a growth may be different. As a rule, neoplasms are the result excess growth tissues at the site of bone injury - this is often observed with fractures, cracks, surgical intervention etc.

But there are other risk factors. According to statistics, with similar problems Children and adolescents most often encounter this, which is often associated with physiological characteristics, namely the intensity of growth. In addition, hereditary connections are often traced. In addition, the causes include various chronic inflammatory bone diseases. Sometimes growths appear against the background of fibrositis and inflammation of the mucous membranes. The cause may be chondromatosis of the bones, as well as aseptic necrosis. Quite often, exostoses develop in people suffering from congenital anomalies skeleton. In addition, growths may indicate a benign bone tumor, being a complication. It is worth noting that doctors are not always able to find out the causes and origin of the disease.

Main symptoms

In most cases, the growths do not cause any discomfort to the person. The disease is asymptomatic and is discovered completely accidentally during scheduled inspection. However, some people have signs that help diagnose exostosis. What are these symptoms?

First of all, it is worth noting the discomfort and pain that occurs when moving, putting pressure on a bone or physical stress(depending on the location of exostoses). The intensity of these symptoms usually increases as the tumor grows. If the growth is located closer to the joint, it can significantly limit the range of motion. Quite often, exostosis can be felt, sometimes even independently.

Modern diagnostic methods

In fact, such a disease is relatively easy to diagnose. The doctor may suspect the presence of a growth even during the examination of the patient, since neoplasms in some places can be easily felt under the skin. Besides, important role History and presenting symptoms play a role in diagnosis.

To confirm the diagnosis, the patient is prescribed X-ray examination. Exostosis is easy to see in the picture. By the way, the actual size of the growth is usually several millimeters larger, since the cartilage tissue is not visible on an x-ray.

In some cases it is required additional research. This is especially true in cases where the growth quickly increases in size, because there is always the possibility of malignant degeneration of the cells. In such cases, patients are prescribed a biopsy, during which tissue samples are taken for further cytological laboratory testing.

Treatment methods

Actually in modern medicine There is only one treatment method - removal of exostosis surgically. Naturally, not every patient needs surgery. After all, as already mentioned, quite often such growths do not pose any threat to health, and the disease proceeds without any visible symptoms. Surgical removal exostosis is necessary if the neoplasm is larger or grows too quickly. In addition, the indication for surgical intervention are severe pain and problems with movement. Some patients agree to surgery if the growth is a severe cosmetic defect.

Modern medical methods make it possible to get rid of tumors in as soon as possible. Bone exostosis is removed through a small incision 1–2 centimeters long. This operation is considered minimally invasive and does not require special training, long-term hospitalization and rehabilitation - as a rule, a few days after the procedure, people begin to gradually return to their normal lives.

Bone exostosis and possible complications

As mentioned, in some cases, even a small bone spur can lead to a host of problems and affect your quality of life. Moreover, there are some complications that exostosis is fraught with. What are these problems? To begin with, it is worth noting that a greatly enlarged tumor often rests on neighboring bones, which leads to their gradual deformation. Complications can also include fractures of the exostosis leg, which, however, is extremely rare. But the greatest danger remains the risk of malignant degeneration. In some patients, the appearance of such a growth was a harbinger of the appearance of a tumor - most often the cancer affects the bones of the pelvis and hip, as well as the vertebrae and shoulder blades.

Exostosis is a benign tumor growth on the surface of the bone. It consists of osteochondral tissue. The pathology is also called osteochondroma. This disease occurs most often in adolescence during active skeletal growth. Osteochondral exostosis can be single or multiple, have different shapes. But usually this pathology is not dangerous and does not cause any negative consequences.

Development mechanism

Most often, the pathology occurs between the ages of 8 and 18 years. In children under 6 years of age, exostosis does not occur, although in many cases it is congenital disease. Overgrowth begins during rapid bone growth.

There are such growths different sizes. Most often they are small - the size of a pea. But there are tumors up to 10 cm and higher. The shape of bone exotosis is often semicircular, it can be in the form of a mushroom cap on a stalk or even in a bunch, in the shape of a cauliflower. Sometimes it appears as a linear growth, for example, in the form of a thorn.

According to statistics, osteochondral growths most often affect the bones of the legs. This is approximately 50% of all diagnosed exostoses. Such cases are almost unknown to medicine. occipital bone and other places of the skull.

The process of formation of bone growth is a gradual ossification of cartilage tissue. It is quite slow, so the tumor is a bone growth covered with a layer of cartilage with a thin bone shell. It is due to cartilage tissue that tumor growth occurs. The growth itself is spongy bone.

Growths of spongy tissue covered with a layer of cartilage like to be localized on tubular bones

Species

The growth can be localized anywhere in the skeleton. But most often there is exostosis on the tibia and fibula, the lower part of the thigh, on the forearm or humerus. Growths can be localized on the ribs, collarbones and even on the vertebral bodies. Slightly less common in children is exostosis of the hand or foot. The growths do not have any peculiarities depending on the location of their appearance, except that they can interfere with and put pressure on neighboring organs or tissues.

TO separate group Exostosis of the gums can be attributed. They most often form in adults, mainly after tooth extraction or complications after treatment. This pathology is diagnosed and treated by a dentist. Osteochondral growths have not yet been observed on the skull bones. But exostoses of the external auditory canal occur. This condition is most often congenital, and therefore develops symmetrically on both sides.

Growths on the joints have minor features. The most common condition is exostosis of the knee joint. It may be congenital or develop after injury. The growth forms either at the end of the femur, or inside the joint itself. This leads to limitation of his mobility, it is especially difficult to straighten his leg.

Pathology has two types. If a single tumor develops, most often on the tibia or femur, they speak of the development of solitary osteochondral exostosis. If there are many growths, this pathology is called multiple exostotic chondrodysplasia. This disease most often has a hereditary nature.

Sometimes multiple exostotic chondrodysplasia develops, in which growths form throughout the body

Reasons

It is believed that osteochondral exostosis develops due to excess calcium in the body. Under the influence of external or internal provoking factors, it settles on the bones of the leg or arm. This pathology can be hereditary, but sometimes this condition appears due to frequent consumption of eggs, dairy products or vitamin preparations without a doctor's prescription.

Causes of bone growths on the femur, arm or torso can also be:

• injury, most often a fracture or even a bruise;
• infectious disease;
• inflammatory process in surrounding tissues;
• pathologies of the development of cartilage tissue or periosteum;
• disruption of the endocrine system.

Increased hardness of the water you drink can also lead to excess calcium in the blood.

Symptoms

Bone exostosis is most often a painless disease. The process of tumor growth occurs slowly, in most cases it does not cause any discomfort or pain to the patient. The skin over the site of growth does not change in any way, there is no swelling or inflammation. Pathology is often discovered accidentally during an X-ray examination. But sometimes the growth on the bone can be felt. And in in rare cases the tumor is so large that it is visible.

Exostosis around a joint often causes pain and limitations in movement.

Sometimes growths cause discomfort. For example, exostosis of the knee joint may cause pain, limited movement, or inflammatory phenomena. When such growths appear on the spine, the resulting compression of the spinal cord causes the following symptoms:

• severe pain;
• sensation of goosebumps and numbness of the skin;
• headaches;
• weakness, dizziness;
• dysfunction of limbs or internal organs.

Diagnostics

This disease is quite difficult to identify, and at the initial stage it is almost impossible. No growth large sizes, especially on the tibia or femur, do not manifest themselves in any way. Only when they are large can the pathology be palpated or even noticed.

But most often exostosis is detected during X-ray examination. Although even in this way it is impossible to determine the real size of the growth. After all, this tumor grows due to the cartilage tissue that makes up its outer layer, but it is not visible on X-rays. In children, this layer can be up to 8 mm. Therefore, it is necessary to take into account that the size of the growth is larger than what is visible on the x-ray.

Although this examination method is the only one for diagnosing this disease, it allows one to determine the shape of the growth and its location. When making a diagnosis, it is important to differentiate such a bone growth from malignant bone tumors. For this, an MRI is also performed.

Complications

One might think that if a pathology does not cause any discomfort, then it is harmless. Indeed, in some cases, a child may undergo spontaneous healing and the tumor will disappear. But when large size they can squeeze growths blood vessels, nerves and nearby organs, disrupting their functioning. Exostosis of the spine is especially dangerous. The growth of such a tumor can lead to compression of the spinal cord. This causes serious neurological disorders.

And with exostosis of the external auditory canal, the growth partially or completely covers it. The result is tinnitus and hearing loss. In addition, complications can occur with exostosis in the joints. Since the pathology occurs during the period of growth and development of the skeleton, bursitis or tendinitis may develop. Impaired functioning of the limb also causes atrophy of muscles and ligaments and the development of arthrosis. And when the bones of the foot are affected, which often happens in adults, difficulties arise in movement, and it is impossible to wear ordinary shoes.

Treatment of exostoses is carried out only surgically

Multiple growths are also a serious pathology. Such exostosis can lead to deformations of the child’s skeleton. After all, at this time its active development occurs, and tumors disrupt its normal formation. Because of this, club hand may develop, growth retardation, knee or knee deformities may occur. elbow joint.

More rare complication is a fracture of the stem of the growth if it has the shape of a mushroom. And when rapid growth such a formation can degenerate into a malignant tumor. This may be chondrosarcoma or spindle cell sarcoma, but this happens no more often than 1% of cases. The most susceptible to degeneration are growths on the hip joint, hips or vertebrae.

Treatment

Treatment of exostosis is only possible with surgery. The growths are not amenable to medication. If this pathology is detected, you must contact an orthopedist or traumatologist. After examination, he will decide whether surgery is necessary. The growth is removed under anesthesia, sometimes under local anesthesia. Its choice depends on the size of the growth and its location. IN lately They are trying to make the operation less traumatic.

The purpose of the operation is to remove bone growth. Sometimes it is necessary to smooth out marginal bone defects, especially if the pathology was inside the joint. In some cases, it is also necessary to remove the periosteum. For small growths on the extremities, the patient is observed on an outpatient basis and leaves the hospital on the day of surgery.

Removal of exostosis in dentistry is carried out under local anesthesia. The operation is performed through a small incision in the gum. Most often the growth is removed with a drill, but sometimes with a laser. Rehabilitation after such an operation lasts from a week to a month, depending on the condition of the patient’s oral cavity and his compliance with the doctor’s recommendations.

Sometimes exostosis in a child can go away without surgery. Therefore, surgical treatment is carried out only after 18-20 years, when skeletal growth stops. Previously, surgery may be prescribed if the growth causes compression of surrounding tissues, pain, or disruption of the functioning of internal organs, for example, when it grows in the rib area. Surgical treatment also indicated for multiple exostoses that interfere with the proper development of the skeleton, for rapid tumor growth or if it leads to serious cosmetic defect, for example, with exostosis in the clavicle area.

Prevention

In most cases, it is difficult to prevent bone exostosis in a child, because the pathology is most often congenital. But it is possible to stop the increased growth and complications arising from this. To do this, you need to regularly undergo preventive examinations at the doctor's.

It is especially important to carry out timely treatment injuries After all, bone growths often form when the blood supply is disrupted or bones do not heal properly. To do this, together with the treatment prescribed by your doctor, you can use folk remedies. Decoctions of comfrey or elderberry help best with bone pathologies, carrot juice, rubbing cinquefoil or golden mustache tincture, compresses made from bear fat. Such methods will help prevent the proliferation of bone tissue if you are predisposed to it.

This pathology in most cases does not pose a particular danger to the life and health of the patient. Removal of the growth occurs without complications or consequences. Therefore, the prognosis for treatment is most often favorable.

Osteochondral exostosis - benign pathology, at which on the surface bone structures cartilage tissue grows. The disease rarely occurs on its own; it often manifests itself as a complication during the progression of other pathologies of a degenerative nature. If the formation does not interfere with the patient and does not impair the functionality of the affected joint, the growth does not need to be removed; it is simply monitored. But in the case when exostosis grows, surgical treatment and postoperative rehabilitation are required.

Causes

The formation of osteochondral exostosis can be observed in children and adults. Such a growth on the bones has a benign etiology and often does not manifest itself, so a person may not even be aware of its existence. But as the cartilage increases in size and ossifies, the patient begins to experience unpleasant symptoms.

The development of education is influenced by the following factors:

• injuries and damage to bone tissue during the period of their intensive formation;
• chronic pathologies of the musculoskeletal system;
• complications due to the progression of viral and infectious diseases;
• congenital skeletal pathologies;
• an excess of calcium in the body, which causes the growth and ossification of cartilage;
• genetic predisposition.

Cartilaginous exostosis mainly occurs as a single growth, but sometimes multiple osteomas are diagnosed when growths form simultaneously in different areas skeleton. This disorder often occurs in children with a hereditary predisposition.

Localization of osteochondral exostosis

Marginal exostoses on the spine actively grow and increase in size, which can lead to disability.

This pathology often affects the structures of the scapula, shoulder and elbow joints, hand and phalanges of the fingers. Often a growth forms on the rib, in the area of ​​the tibia, hip, and knee joint. Exostoses of the spine are extremely dangerous, in which marginal osteomas disrupt the mobility of the vertebrae and also compress the nerve fibers and blood vessels that supply the brain. This disease is also dangerous because the likelihood of degeneration into malignant growths increases.

If exostosis affects bones hip joint, localized in the area of ​​the head and acetabulum, the functioning of the articulation is greatly impaired. Inflammation develops, the bones of the joint become deformed, and the person becomes disabled. The feet are least commonly affected. Mainly affected are the heels and joints 1 metatarsal. Plantar fasciitis is often confused with plantar fasciitis, resulting in inadequate treatment.

Characteristic symptoms

Exostotic chondrodysplasia may be asymptomatic, but if the size of the process increases, the person begins to experience pain and discomfort. Exostosis of the femur, humerus, ulna and ilium disrupts normal functioning limbs. A growth formed on the hands or fingers provokes severe pain in the phalanx, subungual exostosis leads to deformation and complete destruction nail plate.

How dangerous is the disease?

Growths in cervical spine spine provoke insufficient blood supply brain.

It is dangerous when the formation grows in the vertebrae of the thoracic and occipital areas of the spine. Cervical vertebrae permeated a large number vessels and nerve fibers. If a ventral exostosis forms, it begins to deform intervertebral disc, as a result of which the arteries and nerves are compressed, the brain begins to experience hypoxia. Ventral hernias prevent the affected vertebra from functioning normally, and if such disorders are not removed in a timely manner, the situation may end fatal. And also when unfavorable factors bone exostosis on the leg, right or left arm can degenerate into a malignant form.

Diagnostic procedures

Diagnosis of exostosis begins in the doctor’s office, who palpates the diseased area, examines other areas, and collects anamnesis. To determine the nature of the growth on the collarbone, fibula, elbow or knee joint, radiography is performed. Histology is necessary if malignancy in the cartilage is suspected. When will it be possible to install accurate diagnosis, the doctor will determine how to treat the problem and whether it is worth removing.

What treatment is prescribed?

It is necessary to minimize exposure to open sun rays.

If exostosis of the calcaneus, hip, knee or elbow does not cause discomfort and does not impair the functioning of the limbs, it is recommended to simply observe the pathology, while conservative methods are not prescribed for this diagnosis. Often a person notices that the growth has resolved on its own, without treatment. It is important to limit exposure to the sun; there are also contraindications for physiotherapeutic procedures, which can provoke the degeneration of exostosis into a malignant tumor.

When is resection necessary?

Removal surgery is necessary when the osteoma has grown to a large size and can cause negative consequences. Exostosectomy is mandatory if occipital exostosis is diagnosed, in which there is a high probability of destruction of intervertebral structures and compression of nerve fibers and blood vessels. The type of surgery is selected by the doctor, who takes into account the size of the formation and its location. To remove plantar growths, as well as exostosis on thumb legs, Shede's operation is prescribed.

During surgery, the growth is removed and the periosteum that is located next to it is scraped off. The manipulations are carried out through a small puncture; due to the low level of trauma, the patient can leave the hospital on the same day; rehabilitation in this case takes no more than 2 weeks. Often postoperative complications do not occur, the person recovers completely, the disease is not prone to relapse.

Treatment with folk remedies

In the background improper treatment the tumor can develop into malignant.

Exostosis cannot be treated conservatively, so any recipes traditional medicine powerless and sometimes unsafe. When the growth increases in size and begins to hurt, people try to get rid of the symptoms with improvised means, often causing complications. Do not forget that this pathology can degenerate into a malignant tumor, so therapy with even the most harmless folk remedies may be unsafe.

Prevention

There are no special preventive measures to prevent such a disease.

Osteochondral exostosis is a benign cartilaginous bone tumor, also known as osteochondroma.

Osteochondroma begins its development from the epiphyseal growth plate - a section of hyaline cartilage in long tubular bones, thanks to which the child’s bones grow in length. At the very beginning, osteochondroma is a cartilaginous formation, which then ossifies in the middle, and the outside remains covered with a thin layer of cartilage. It is due to outer shell Osteochondroma grows from cartilage tissue.

The epiphyseal plate functions in children and adolescents until skeletal growth ends, until approximately 18-20 years of age.

Causes

Multiple congenital osteochondromas are a manifestation of a hereditary disease.

Single osteochondromas can develop for a number of reasons:

• On the spot inflammatory process developed as a result of injury, bruise, infection (including syphilis);
• Features of the development of periosteum and cartilage;
• Various disorders in the functioning of the endocrine glands.

Symptoms

As a rule, osteochondromas appear in children and adolescents aged 10-20 years. They grow as long as the skeleton is actively growing. And, as a rule, they stop growing by the age of 18-20, when the skeleton is already fully formed. In rare cases, osteochondromas may appear and continue to grow after age 30.

In most cases they appear osteochondral exostoses near the ends of long tubular bones, near joints and grow away from the joint. Most often, exostoses are found on the femoral and tibia, bones of the forearm. Exostoses can be found in the pelvic bones, ribs, shoulder blades, collarbones, and vertebrae. Less common bone formations on the bones of the phalanges of the fingers in the form of subungual growths up to 1 cm in diameter.

If the growth of osteochondroma leads to deformation and peeling of the nail, then the process may be accompanied by severe pain. Osteochondromas in other parts of the body are always painless. The appearance of pain in such cases indicates a malignant degeneration of exostosis.

Patients discover exostoses accidentally when palpating any area of ​​the body. Or they are accidentally found on x-rays or during examination for other reasons.

An exception to this rule is exostosis of the knee joint and exostosis of the vertebral bodies..

Exostosis of the knee joint develops from the femur in the immediate vicinity of the knee joint, under the quadriceps femoris muscle. The quadriceps femoris muscle is one of the stabilizers of the patella and plays a dominant role in the process of extension of the knee joint. Growing exostosis puts pressure on the quadriceps femoris muscle. This leads to stretching and deformation of the muscle, often a mucous bursa develops underneath it. The pressure of a growing exostosis on the bone in some cases leads to a fracture and the formation of an exostosis in the area of ​​the leg. The literature describes cases of intra-articular growth of osteochondroma, which leads to inflammation in the joint and rapid disruption of its function.

Exostoses of vertebral bodies can grow inward spinal canal and lead to spinal cord damage.

Diagnostics

On an x-ray, osteochondromas are always associated with bone, have a distinct round or mushroom-shaped outline, and the cartilaginous shell is not visible on an x-ray. The size of osteochondroma can be from 1 cm to 5-6 cm in diameter.

Treatment of osteochondral exostosis

If exostoses are small in size, do not increase in size after 18-20 years, do not injure or compress internal organs, then they are periodically monitored. No treatment is provided in these cases. Physiotherapy is contraindicated in areas where exostoses grow, so as not to provoke the degeneration of osteochondroma into a malignant tumor.

Large osteochondromas that cause discomfort or interfere with joint movement are removed surgically. During surgery, exostosis is removed within healthy bone tissue. The periosteum adjacent to the tumor is also removed to avoid recurrence of osteochondroma. Such operations can be performed both under local anesthesia and under general anesthesia, depending on the complexity of the proposed operation.