Presentation
Chronic bilateral knee pain. Limitation of joint movements more in extension.
Patient Data
Plain radiograph showing bilateral multiple benign growths of bone extending outwards from the surface of distal femur, proximal tibia and fibula.
A picture consistent with multiple exostoses of both knee joints.
Bilateral osteoarthritis changes in both knee joints more in the right side.
Two months later.
Right side total knee replacement was done for pain relief and retaining joint function.
Case Discussion
Hereditary multiple exostoses is an autosomal dominant disease characterized by formation of multiple osteochondromas, most common site is distal femur and proximal tibia (70% of cases). The disease caries a risk for malignant transformation.
Depending on their location the exostoses can cause the following problems: pain or numbness from nerve compression, vascular compromise, inequality of limb length, irritation of tendon and muscle.