Osteochondroma: Difference between revisions
No edit summary |
No edit summary |
||
| Line 1: | Line 1: | ||
| | ||
<div class="noeditbox">Welcome to [[Pathophysiology of Complex Patient Problems|PT 635 Pathophysiology of Complex Patient Problems]] This is a wiki created by and for the students in the School of Physical Therapy at Bellarmine University in Louisville KY. Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!</div> <div class="editorbox"> | <div class="noeditbox">Welcome to [[Pathophysiology of Complex Patient Problems|PT 635 Pathophysiology of Complex Patient Problems]] This is a wiki created by and for the students in the School of Physical Therapy at Bellarmine University in Louisville KY. Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!</div> <div class="editorbox"> | ||
'''Original Editors '''- James Mountain [[Pathophysiology of Complex Patient Problems|from Bellarmine University's Pathophysiology of Complex Patient Problems project.]] | '''Original Editors '''- James Mountain [[Pathophysiology of Complex Patient Problems|from Bellarmine University's Pathophysiology of Complex Patient Problems project.]] | ||
| Line 5: | Line 5: | ||
'''Lead Editors''' - Your name will be added here if you are a lead editor on this page. [[Physiopedia:Editors|Read more.]] | '''Lead Editors''' - Your name will be added here if you are a lead editor on this page. [[Physiopedia:Editors|Read more.]] | ||
</div> | </div> | ||
== Definition/Description == | == Definition/Description<br> == | ||
Osteochondroma is the most common benign bone tumor and can present as solitory osteochondroma or as multiple osteochondromatosis AAOS). These tumors account for 8.5% of all bone tumors and while representing 36% of all non-malignant bone tumors (Yoshiba et al). | |||
Osteochondroma is the most common benign bone tumor representing 8.5% of all bone tumors and 36% of all non-malignant bone tumors (Yoshida et al). These tumors usually arise from the metaphysis (the growth plate) of long bones, such as the femur, but can occur at other cortical bone metaphyses (Abraham). They can | |||
The knees are the most common site for osteochondromas to occur (Frey). Osteochondroma is often referred to as , also referred to as osteocartilaginous exostosis or plainly exostosis, | |||
These non-malignant tumors can arise as solitary osteochondromas or as multiple osteochondromas(AAOS). | |||
<br> | |||
<br> | |||
| |||
<span class="Apple-style-span" style="font-size: 20px;"></span> | |||
<span class="Apple-style-span" style="font-size: 20px;">Prevalence</span> | |||
add text here <br> | add text here <br> | ||
Occurs predominantly in males with a 3:1 ratio compared to females (Yoshida). Average age of clinical presentation is 10 to 30 years of age (Moon, AAOS). | |||
<br> | |||
== Characteristics/Clinical Presentation == | == Characteristics/Clinical Presentation == | ||
Occurs predominantly in males with a 3:1 ratio compared to females (Yoshida). Average age of clinical presentation is 10 to 30 years of age (Moon, AAOS). | |||
<br> | |||
== Associated Co-morbidities == | == Associated Co-morbidities == | ||
Radiculopathies and myelopathy may occur if the osteochondroma presents in the spine and places pressure on the spinal cord and/or nerve roots (Moon. | |||
== Medications == | == Medications == | ||
Pain medication only if symptoms of pain present (AAOS)<br> | |||
== Diagnostic Tests/Lab Tests/Lab Values == | == Diagnostic Tests/Lab Tests/Lab Values == | ||
The excess bone growth can usually be picked up on a plain X-rays (AAOS). A magnetic resonance imaging (MRI) can be used to examine whether or not cartilage is present on the surface of the exostosis (Woertler). If cartilage is indeed present it should be checked for cancer, especially if it measures more than two centimeters in size and pain is present. A CT scan may also be used (AAOS). | |||
add text here <br> | add text here <br> | ||
== Etiology/Causes == | == Etiology/Causes == | ||
The etiology regarding the development of solitary osteochondroma is currently unknown, however it may be related to genetic predisposition (Frey). Multiple osteochondromas have been associated with EXT 1 and EXT 2 genes. The association is currently not well understood and research is continuing to look into the link (AAOS). | |||
add text here <br> | add text here <br> | ||
| Line 39: | Line 65: | ||
== Medical Management (current best evidence) == | == Medical Management (current best evidence) == | ||
add text here | Options regarding medical management of osteochondroma is indicated only if symptoms are present. The options include 1. pain medication and/or 2. surgery. Either options depends on a variety of factors including age, severity, disease extent, overall health etc. | ||
Solitary osteochondromas generally do not require surgery and are usually monitored with regular X-rays. Surgery for solitary osteochondromas are only suggested when the exostosis has grown completely and a mature skeleton is observed on an X-ray. The reason for this is to decrease the chance of reoccurrence. When surgery may be considered: 1. pain with activity 2. pressure on a nerve or blood vessel 3. presents with a larger cartilage cap (AAOS). | |||
Multiple Osteochondromas - | |||
<br> add text here | |||
== Physical Therapy Management (current best evidence) == | == Physical Therapy Management (current best evidence) == | ||
| Line 50: | Line 82: | ||
== Differential Diagnosis == | == Differential Diagnosis == | ||
Osteosarcoma – a malignant bone tumor | |||
add text here | add text here | ||
| Line 69: | Line 103: | ||
== References == | == References == | ||
see [[Adding References|adding references tutorial]]. | 1. American Academy of Orthopaedic Surgeons. Osteochondroma (bone tumor). http://orthoinfo.aaos.org/topic.cfm?topic=A00079. 2007. Accessed March 16, 2011. 2. Chin K, Kharrazi F, Miller B, Mankin H, Gebhardt M. Osteochondromas of the distal aspect of the tibia or fibula. Journal of Bone and Joint Surgery. 2000;82:1269. 3. Errani C, Jutte P, De Paolis M, Bacchini P, Mercuri M. Secondary synovial condromatosis in a bursa overlying an osteochondroma mimicking a peripheral chondrosarcoma-a case report. Acta Orthopaedica. 2007;78(5):701-704. 4. Feeley B, Kelly B. Arthroscopic management of an intraarticular osteochondroma of the hip. Orthopaedic Reviews. 2009;1(2):1-5. 5. Frey K, Hosey R, Milbrandt T. Tibial osteochondroma in a high school football player. Human Kinetics – Att. 2008;13(6):36-37. 6. Goodman C, Fuller K. Pathology 3rd ed. Saunders Elsevier 2009: 1227-1228. 7. Merck Manuals. Bone and joint tumors. Merck Manual Home Edition. http://www.merckmanuals.com/professional/sec04/ch044/ch044b.html. Accessed February 23, 2011. 8. Moon K, Lee J, Kim Y, Kwak H, Joo S, Kim I, Kim J, Kim S. Osteochondroma of the cervical spine extending multiple segments with cord compression. Pediatric Neurosurgery. 2006;42:304-307. 9. Murphey MD, Choi JJ, Kransdorf MJ, Flemming DJ, Gannon FH. Imaging of the -osteochondroma: variants and complications with radiologic-pathologic correlation. Radiographics. 2000;5:1407-1434 10. Ratliff J, Voorhies R. Osteochondroma of the C5 lamina with cord compression: case report and review of the literature. Spine. 2000; 25(10):1293-1295. 11. Roa A, Abraham G, Rajshekhar V. Osteochondroma of rib with neural foraminal extension and cord compression. Neurology India. 2007;55(4):428-429. 12. Robbins M, Kuo S, Epstein R. Non-traumatic fracture of an osteochondroma mimicking malignant degeneration in an adult with hereditary multiple exostoses. Radiology Case Reports. 2008;3:99. 13. Samartzis D, Marco R. Osteochondroma of the sacrum: a case report and review of the literature. Spine. 2006;31(13):425-429. 14. Yoshida T, Matsuda H, Horiuchi C, Taguchi T, Nagao J, Aota Y, Honda A, Tsukuda M. A case of osteochondroma of the atlas causing obstructive sleep apnea syndrome. Acta Oto-Laryngologica. 2006;126:445-448. 15. Woertler K, Lindner N, Gosheger G, Brinkschmidt C, Heindel W. Osteochondroma: MR imaging of tumor-related complications. Eur Radiol. 2000;10(5):832-840. | ||
<br> see [[Adding References|adding references tutorial]]. | |||
<references /> | <references /> | ||
[[Category:Bellarmine_Student_Project]] | [[Category:Bellarmine_Student_Project]] | ||
Revision as of 20:10, 2 April 2011
Original Editors - James Mountain from Bellarmine University's Pathophysiology of Complex Patient Problems project.
Lead Editors - Your name will be added here if you are a lead editor on this page. Read more.
Definition/Description
[edit | edit source]
Osteochondroma is the most common benign bone tumor and can present as solitory osteochondroma or as multiple osteochondromatosis AAOS). These tumors account for 8.5% of all bone tumors and while representing 36% of all non-malignant bone tumors (Yoshiba et al).
Osteochondroma is the most common benign bone tumor representing 8.5% of all bone tumors and 36% of all non-malignant bone tumors (Yoshida et al). These tumors usually arise from the metaphysis (the growth plate) of long bones, such as the femur, but can occur at other cortical bone metaphyses (Abraham). They can
The knees are the most common site for osteochondromas to occur (Frey). Osteochondroma is often referred to as , also referred to as osteocartilaginous exostosis or plainly exostosis,
These non-malignant tumors can arise as solitary osteochondromas or as multiple osteochondromas(AAOS).
Prevalence
add text here
Occurs predominantly in males with a 3:1 ratio compared to females (Yoshida). Average age of clinical presentation is 10 to 30 years of age (Moon, AAOS).
Characteristics/Clinical Presentation[edit | edit source]
Occurs predominantly in males with a 3:1 ratio compared to females (Yoshida). Average age of clinical presentation is 10 to 30 years of age (Moon, AAOS).
Associated Co-morbidities[edit | edit source]
Radiculopathies and myelopathy may occur if the osteochondroma presents in the spine and places pressure on the spinal cord and/or nerve roots (Moon.
Medications[edit | edit source]
Pain medication only if symptoms of pain present (AAOS)
Diagnostic Tests/Lab Tests/Lab Values[edit | edit source]
The excess bone growth can usually be picked up on a plain X-rays (AAOS). A magnetic resonance imaging (MRI) can be used to examine whether or not cartilage is present on the surface of the exostosis (Woertler). If cartilage is indeed present it should be checked for cancer, especially if it measures more than two centimeters in size and pain is present. A CT scan may also be used (AAOS).
add text here
Etiology/Causes[edit | edit source]
The etiology regarding the development of solitary osteochondroma is currently unknown, however it may be related to genetic predisposition (Frey). Multiple osteochondromas have been associated with EXT 1 and EXT 2 genes. The association is currently not well understood and research is continuing to look into the link (AAOS).
add text here
Systemic Involvement[edit | edit source]
add text here
Medical Management (current best evidence)[edit | edit source]
Options regarding medical management of osteochondroma is indicated only if symptoms are present. The options include 1. pain medication and/or 2. surgery. Either options depends on a variety of factors including age, severity, disease extent, overall health etc.
Solitary osteochondromas generally do not require surgery and are usually monitored with regular X-rays. Surgery for solitary osteochondromas are only suggested when the exostosis has grown completely and a mature skeleton is observed on an X-ray. The reason for this is to decrease the chance of reoccurrence. When surgery may be considered: 1. pain with activity 2. pressure on a nerve or blood vessel 3. presents with a larger cartilage cap (AAOS).
Multiple Osteochondromas -
add text here
Physical Therapy Management (current best evidence)[edit | edit source]
add text here
Alternative/Holistic Management (current best evidence)[edit | edit source]
add text here
Differential Diagnosis[edit | edit source]
Osteosarcoma – a malignant bone tumor
add text here
Case Reports/ Case Studies[edit | edit source]
add links to case studies here (case studies should be added on new pages using the case study template)
Resources
[edit | edit source]
add appropriate resources here
Recent Related Research (from Pubmed)[edit | edit source]
see tutorial on Adding PubMed Feed
Extension:RSS -- Error: Not a valid URL: Feed goes here!!|charset=UTF-8|short|max=10
References[edit | edit source]
1. American Academy of Orthopaedic Surgeons. Osteochondroma (bone tumor). http://orthoinfo.aaos.org/topic.cfm?topic=A00079. 2007. Accessed March 16, 2011. 2. Chin K, Kharrazi F, Miller B, Mankin H, Gebhardt M. Osteochondromas of the distal aspect of the tibia or fibula. Journal of Bone and Joint Surgery. 2000;82:1269. 3. Errani C, Jutte P, De Paolis M, Bacchini P, Mercuri M. Secondary synovial condromatosis in a bursa overlying an osteochondroma mimicking a peripheral chondrosarcoma-a case report. Acta Orthopaedica. 2007;78(5):701-704. 4. Feeley B, Kelly B. Arthroscopic management of an intraarticular osteochondroma of the hip. Orthopaedic Reviews. 2009;1(2):1-5. 5. Frey K, Hosey R, Milbrandt T. Tibial osteochondroma in a high school football player. Human Kinetics – Att. 2008;13(6):36-37. 6. Goodman C, Fuller K. Pathology 3rd ed. Saunders Elsevier 2009: 1227-1228. 7. Merck Manuals. Bone and joint tumors. Merck Manual Home Edition. http://www.merckmanuals.com/professional/sec04/ch044/ch044b.html. Accessed February 23, 2011. 8. Moon K, Lee J, Kim Y, Kwak H, Joo S, Kim I, Kim J, Kim S. Osteochondroma of the cervical spine extending multiple segments with cord compression. Pediatric Neurosurgery. 2006;42:304-307. 9. Murphey MD, Choi JJ, Kransdorf MJ, Flemming DJ, Gannon FH. Imaging of the -osteochondroma: variants and complications with radiologic-pathologic correlation. Radiographics. 2000;5:1407-1434 10. Ratliff J, Voorhies R. Osteochondroma of the C5 lamina with cord compression: case report and review of the literature. Spine. 2000; 25(10):1293-1295. 11. Roa A, Abraham G, Rajshekhar V. Osteochondroma of rib with neural foraminal extension and cord compression. Neurology India. 2007;55(4):428-429. 12. Robbins M, Kuo S, Epstein R. Non-traumatic fracture of an osteochondroma mimicking malignant degeneration in an adult with hereditary multiple exostoses. Radiology Case Reports. 2008;3:99. 13. Samartzis D, Marco R. Osteochondroma of the sacrum: a case report and review of the literature. Spine. 2006;31(13):425-429. 14. Yoshida T, Matsuda H, Horiuchi C, Taguchi T, Nagao J, Aota Y, Honda A, Tsukuda M. A case of osteochondroma of the atlas causing obstructive sleep apnea syndrome. Acta Oto-Laryngologica. 2006;126:445-448. 15. Woertler K, Lindner N, Gosheger G, Brinkschmidt C, Heindel W. Osteochondroma: MR imaging of tumor-related complications. Eur Radiol. 2000;10(5):832-840.
see adding references tutorial.
