Hereditary multiple exostoses

Case contributed by Bahman Rasuli
Diagnosis certain

Presentation

Right leg pain.

Patient Data

Age: 10 years
Gender: Male

Multiple benign growths of bone extending outwards from the surface of the proximal and distal tibia and fibula

Large exostosis originating from distal tibia diaphysis in the lateral aspect producing erosion and marked thinning impending fibula fracture.

Case Discussion

Hereditary multiple exostoses is an autosomal dominant disease characterized by the formation of multiple osteochondromas, most common site is the distal femur and proximal tibia (70% of cases). The disease carries a risk for malignant transformation. Depending on their location the exostoses can cause the following problems: pain or numbness from nerve impingement, vascular compromise, inequality of limb length, irritation of tendon, and muscle.

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