Hereditary multiple exostoses (bilateral knee)

Case contributed by Dr Mohamed Hossam el Deen

Presentation

Chronic bilateral knee pain. Limitation of joint movements more in extension.

Patient Data

Age: 56
Gender: Female
Modality: X-ray

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.

Modality: X-ray

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.

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Case Information

rID: 39301
Case created: 30th Aug 2015
Last edited: 13th Sep 2015
Inclusion in quiz mode: Included

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