Osteochondroma - Causes, Symptoms, and Treatment

Introduction:

Osteochondroma is one of the most commonly occurring non-cancerous growths. The term osteochondroma, when broken down, means osteo - bone, chondro - cartilage, and oma - tumor. This overgrowth occurs on the cartilage and the bone endings; near the growth plates. It is commonly seen in children and teenagers. It usually starts during the childhood period and stops when the skeleton ceases to grow. This article will throw light on the causes, symptoms, and treatment.

What Are the Different Types of Osteochondroma?

There are two main types of osteochondromas:

• Solitary Osteochondroma: This type of osteochondroma refers to a single tumor. It develops near the growth plate of a bone. The growth plate is a region of growing tissue that helps bones to lengthen during childhood. These are usually not painful and do not cause many problems. In case the tumor becomes large, it may lead to symptoms such as pain, restricted movement, or cosmetic concerns.

• Multiple Hereditary Osteochondromas (MHO): It is also known as multiple hereditary exostoses. This type of osteochondroma involves the development of multiple tumors. It is a genetic condition that tends to run in families. People with MHO can develop multiple osteochondromas throughout their bodies. This can cause more significant symptoms and complications compared to solitary osteochondromas. These include deformities, nerve compression, joint limitations, and an increased risk of developing other bone-related problems.

What Are the Causes of Osteochondroma?

The exact causes of osteochondromas are not fully understood. However, there are a few factors that may contribute to their development:

• Genetic Mutations: In the case of multiple hereditary osteochondromas (MHO), the condition is usually inherited in an autosomal dominant manner. This means that a mutation in a specific gene is passed down from one generation to the next.

• Somatic Mutations: In solitary osteochondromas, it is believed that somatic mutations occur spontaneously during the growth and development of bones. Somatic mutations are genetic changes that happen after conception and are not inherited from parents. These mutations can affect the cells responsible for bone growth, forming a single osteochondroma.

• Growth Plate Abnormalities: Osteochondromas often develop near the growth plates of bones. Abnormalities in the growth plates may contribute to the development of osteochondromas. However, the exact mechanisms behind this relationship still need to be better understood.

What Are the Symptoms of Osteochondroma?

In many cases, osteochondromas may be asymptomatic and discovered incidentally during routine medical examinations or imaging tests. However, some of the symptoms include:

• Visible or Palpable Bumps: Osteochondromas often present as firm, painless bumps or lumps near the ends of long bones. These can be felt through the skin or may be visible as a protrusion.

• Pain or Discomfort: If an osteochondroma grows large or impinges on surrounding tissues, it can cause pain or discomfort. The pain may be dull, achy, or sharp in nature. This may worsen with activity or pressure on the affected area.

• Limited Joint Movement: Osteochondromas located near joints, such as the knee or shoulder, can restrict movement and lead to joint stiffness. This limitation can affect the range of motion and overall function.

• Nerve Compression: In some cases, osteochondromas can compress nearby nerves, resulting in symptoms such as numbness, tingling, or weakness in the affected limb.

• Cosmetically Concerning: Osteochondromas that are large or located in visible areas, such as the arms or legs, can cause cosmetic concerns or self-consciousness.

These symptoms can also be indicative of other conditions, and a proper medical evaluation is necessary for an accurate diagnosis.

How to Diagnose Osteochondroma?

The diagnosis of osteochondromas typically involves a combination of medical history assessment, physical examination, and imaging tests. Here is an overview of the diagnostic process:

• Medical History and Physical Examination: Your healthcare provider will start by discussing your symptoms, medical history, and any family history of bone conditions. They will perform a physical examination to assess the affected area, check for visible or palpable bumps, evaluate a range of motion, and look for any signs of nerve compression or joint limitations.

• Imaging Tests: Imaging tests are crucial for confirming the presence of osteochondromas and determining their size, location, and characteristics. Common imaging modalities used include:

• X-rays: X-rays can provide detailed images of bones and can help identify the presence of osteochondromas. They can also show the structure and shape of the tumor.

• MRI (Magnetic Resonance Imaging): MRI uses powerful magnets and radio waves to produce detailed images of soft tissues, bones, and cartilage. It can help evaluate the extent of the tumor, identify any nerve compression, and assess surrounding structures.

• CT (Computed Tomography) Scan: CT scans use a series of X-ray images taken from different angles to create detailed cross-sectional images of the body. They can provide more precise information about the osteochondroma's size, shape, and location.

• Biopsy: In rare cases where there is uncertainty about the nature of the growth, a biopsy may be performed. A small sample of tissue is removed from the osteochondroma for laboratory analysis to confirm the diagnosis and rule out any malignant transformation.

What Are the Treatment Options for Osteochondroma?

The treatment approach for osteochondromas depends on several factors, including the size, location, and symptoms associated with the tumors. In many cases, observation and monitoring may be sufficient, especially if the osteochondroma is small, asymptomatic, and not causing any functional limitations. However, if the osteochondroma is causing symptoms or complications, treatment options may include:

• Surgical Removal (Excision): Surgical removal is often recommended if the osteochondroma is causing significant pain, functional impairment, nerve compression, or cosmetic concerns. During the procedure, the tumor is carefully excised from the bone, aiming to remove it completely while preserving the surrounding healthy tissues.

• Monitoring and Follow-up: If the osteochondroma is small, asymptomatic, and not causing any complications, the healthcare provider may choose a conservative approach of monitoring the tumor over time. Regular follow-up appointments and imaging tests can be scheduled to monitor any changes in size, symptoms, or potential malignant transformation.

• Physical Therapy: Physical therapy may be recommended to improve joint mobility, strengthen surrounding muscles, and manage pain or functional limitations associated with the osteochondroma. Physical therapy can be especially beneficial after surgical removal of the tumor to aid in rehabilitation and optimize recovery.

• Pain Management: If the osteochondroma is causing pain, over-the-counter pain medications or prescribed pain relievers may be recommended to manage discomfort and improve quality of life.

Conclusion:

In conclusion, osteochondromas are common benign bone tumors that typically develop near the ends of long bones during childhood or adolescence. They can be solitary or multiple, with multiple hereditary osteochondromas being a hereditary condition. While many osteochondromas do not cause symptoms and may only require monitoring, treatment options such as surgical removal, physical therapy, and pain management are available for symptomatic or complicated cases. Consulting with a healthcare professional is crucial for an accurate diagnosis and appropriate management.