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Osteochondroma , solitary and multiple . Everything You Need To Know - Dr. Nabil Ebraheim
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- čas přidán 24. 01. 2016
- Dr. Ebraheim’s educational animated video describes the condition of osteochondroma. Osteochondroma is a surface lesion that arises from the surface of the bone and continues with the medullary cavity. It arises from a trapped growth plate cartilage that herniates through the cortex and grows via the endochondral ossification beneath the periosteum.
The cartilaginous cap produces the bony mass by progressive endochondral ossification. It is the most common benign bone tumor.
Presentation: Mass swelling and pain or discomfort. Pain can originate from the bursa or due to mechanical impingement. Pain may also occur due to fracture of the stalk.
Locations: Distal femur, proximal tibia, proximal femur, proximal humerus. Osteochondroma can occur however, in any bone in which endochondral ossification occurs. Growth of the osteochondroma parallels the growth of the patient. The lesion will stop growing once the physis closes.
X-ray: The cortex of the medullary cavity is continuous. The lesion may be either sessile (uncommon) or pedunculated (common). The base of the lesion is wider with high risk of malignancy in sessile. A pedunculated lesion is a narrow stalk that usually grows away from the joint. Osteochondroma often arises at the site of tendon insertion. The direction of the growth follows along the tendon line.
MRI will show the cartilage cap better than an x-ray. The cap is usually 2-3 mm in thickness. It may be 1 cm thick in a grown child. The thicker cap indicates growth, however, it is not a reliable indication of malignant transformation.
The patient may have a bursa on top of the lesion and there may be calcified or ossified loose bodies. The cartilaginous cap is made of hyaline cartilage and it has chondrocytes that are benign with a single nucleus usually arranged in clusters and parallel similar to the physis. If the cartilage cap becomes thicker in adults (more than 2 cm), the rule out chondrosarcoma.
Multiple hereditary exostoses is a disorder that is characterized by multiple osteochondromas. The lesions are similar in x-ray appearance and histologically to solitary osteochondroma. It may have metaphyseal widening and sessile lesions. It is autosomal dominant with incomplete penetrance in females. It is more common in males. It occurs due to a gene mutation EXT1, EXT2, EXT3. In EXT1, there will be more severe presentation such as more limb malalignment and decreased range of motion of the knee and elbow. EXT1 will have more extostoses and more malignancy than in EXT2. Malignant transformation solitary is less than 1% and multiple is about 10%. Proximal lesions tend to undergo more malignant transformation than distal lesions. If it transforms to malignant, then the lesion will be low grade chondrosarcoma. This usually occurs in the pelvis.
Presentation: Short stature (shortened femur), skeletal deformities (site of limb deformities is usually the knee, forearm and ankle), coxa valga, knee valgus with short fibula and patellar dislocation, and ankle valgus due to a shortened fibula. In the upper extremity, there may be radial bowing with the ulna shortened, the radial head dislocated and ulnar deviation of the hand (treated by an osteotomy and exostosis excision). The condition is similar to Madelung’s deformity.
Malignant transformation: Clinically, any new pain or sudden increase in size of the lesion will signal low grade chondrosarcoma that usually occurs in the scapula or pelvis. Asses the cartilage cap (MRI will show the cap as a bright sign). It occurs more in the sessile type showing an area of lucency or destruction of the base of the oteochondroma or destruction of the adjacent bone. May also find presence of a calcified soft tissue mass. Usually occurs in older patients.
Differential diagnosis includes periosteal osteosarcoma and myositis ossificans.
Treatment: Observation if the patient is asymptomatic. Excision after skeletal maturity is usually done if there is a presence of pain, cosmetic deformity or loss of range of motion. Need to be aware of any loss of pronation and supination in the forearm. A wide surgical excision will be done in case of a secondary chondrosarcoma.
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I had a large osteochondroma surgically removed about 3 months ago right above my knee cap on my thigh, it was probably the most scary experience of my life but luckily it was a simple removal and I was only in the hospital for a day but was in crutches for quite a while. I’m so glad I got it removed though, and now I can flex on all my friends I got a big scar on my leg 😂
How are you today plz tell me
I had to have surgery twice on my same leg to get a big one removed. Little bugger grew back.
@@Misscouchpotato- I’m allgs now, they put some glue stuff on the wound to stop it from growing back
@@Hamish_Productions oh, well they didn't do that for me and I don't know your age (nor do I need to know) I was young when I got my first on removed maybe around 2015/2016. Had to get my second one removed around 2022.
I had to get mine removed because it was really painful! I have lost feeling in the front of my knee but it doesn't bother me too much.
nice, i'm jealous! i have multiple hereditary exostoses so i have a surgery one once a year.
Very helpful, Many Thanks
I had it one my left foot right above my knee cap for about years. When I lost about 24 kg it got more visible as a bump on my foot. Consulted most of the orthopaedic doctors and all of them advised me to have it removed through excision. It's been 2 weeks that I got it removed and now waiting for my biopsy.
i have osteochondroma and my leg is locked right now. the orthopedic told me i should massage the bone and that’s what i’ve been doing the past 10 minutes and it really hurts. i need more things to help it unlock help !
I'm impressed great lesson. Thank you.
thanks for amazing explanation.🙏
thank you sir... such a simple video covering everything about OC...
I was diagnosed with an osteo condroma on my right shin, under the knee joint last year... Is it normal to have constant sharp pain that involves the knee, and radiates the shaft to the ankle, also swelling around the bones surrounding the lower part, from the knee to the ankle? I would greatly appreciate your opinion sir. Thank you.
@@darkwolf2556 i suggest to get it removed when you have stopped growing around age 20+ as it may grow back when you're still young. Just undergo the surgery for my left leg and now recovering, surgery took around 1hour only
@@queeniu4184 yes I agree. I had to have one removed twice because it grew back. I was in so much pain it was hard to walk.
Can a osteochondroma ever present as a capsule with multiple bones, with a blood supply going back to within the elbow joint? This is what I have on the medial side of my elbow and it is very painful as the ulnar nerve is being trapped by it. I am not convinced that it is a osteochondroma
Thank you for this. I have Multiple Hereditary Exostoses and this was very informative.
James O'Connor I have them all through out my body but mainly on my legs
Alexander Antonellis me too! Also a bowed left forearm. Does your family have it as well or just you?
James O'Connor all but 2 of my cousins on my dads side
James O'Connor my grand father, dad and one of my aunts has them bad of the legs and my other aunt has Em bad on the arms and my uncle has them in his back. And I got them all over. I don't have a bowed arm but some of my fingers are crooked and my ankle leans inward and I've had lots of surgeries to correct it
Same i have it to but none of my close family had it maybe my ancestors did. But i am really terrified of malignancy and it turning into cancer...
My friend had this and it looked like his leg was longer than the other. He got it removed and now he has this scar left on his leg. At least it has been removed and it no longer hurts.
Wow same here
@@handfull653 Dang.
Gokan the Husky I was wondering was he able to get back to working out after his surgery ? I’m about to get my surgery done soon
@@handfull653 Yeah. After he got it removed, he was able to move and work out again. He was more mobile.
@@handfull653 I have this too, in my knee, and i'm having a hard time decinding on wether i should or should not get surgery. Would you mind answering a few questions to help me?
Where in your body did you have the problem?
Was the surgery a good decition?
How wad the recovery?
Can you fully function now?
Thank you very much🙏
this literally saved me before my orthopedics exam.thanks a lot.😘
Hello can i live with an osteochondroma in the clavicle (collar bone ?
Thanks a lot sir
I know this is late but i think or am relatively positive that i have osteochondroma (left leg, distal, lateral). Its pretty big like i can palm the thing. I like to call it my 3rd knee. Most people dont notice it until i point it out. It doesnt cause any problems with everyday living, but when im on extended drives where i dont get to stretch my knee. It will get numb and uncomfortable. No pain though. I also noticed that if i dont stretch and i do a explosive squat jump (or any squatting motion). The muscles will get caught on the osteochondroma. (Idk how to explain this but its like the muscles have to roll over the osteochondroma. I was thinking about surgery, but was wondering how long will the recover last? Its a invasive af surgery, guess im just nervous
I had an extremely large osteochondroma of the left distal femur removed at the age of 15. The surgery took about 8 hours and removed the majority of the left femur and I wasn’t able to walk for close to 6-7 months at all. I had to have 2 more removed from the same spot at 17 and 3 at 19. Since then the bone hasn’t grown all the way back ( I like to pretend an x-ray is a nice mountain range view). Left leg also unfortunately stopped growing at the first excision. This was over 20 years ago and the damn thing still hurts, all the time, anyone else experiencing this? Since the tumor is gone it’s hard to find anyone to look at it longer than 5 minutes and the answer is always the same “you’ve lived with it this long, there’s nothing you can do and it’ll only get worse as you get older”.
I'm so sorry you have to still go through this, hope you find the right help soon
Hy, my experience is same with you. This was over 8 years and it's still hurt. How are you right now?
@@auliamaharani9664 damn I have the same thing Dr. is asking for biopsy I'm scared ...what about u is it removed now??
do you perform surgery even if the outgrowth is still small
Mhm no matter the size they still do.
hello , it can be found in right lower lobe..doctor said it found right 7th rib..plz reply
Please help me I am from Pakistan I had an injury that I can't throw anything had my MRI scan done my rotator cuff is not teared it was written that some thing like Fibrosis had my physiotherapy sessions ate lots of medicines rested alot still I am there where I was no doctor is guiding me what to do
Amazing...
Thanks
I have multiple hereditary osteochondromas
How do we have this
i remove the chondromatosis in my joint with arthroscopic but they remake in my joint why please tell me
At what stage exostoses suppose to be operated
thanks for sharing...
got it on my right shoulder after an accident at 16.removed it at 17!
I have it in my left knee, and don't know if u should do the surgery to remove it, would you mind telling me about your case?
Why did it happen?
How did it affect you?
How did you remove it?
Did it dissapear completly afterwards?
Would you reccomend surgery?
How much time did the recovery take?
Thank you so much🙏
@@tal2939 it didn’t hurt . It was just too big. They kept an eye on it for about one and a half year before removing it .
@@JOHNNYwxw Thanks for replying!
How was the recovery from the surgery like? Did it grow again after surgery? Did you fully recover?
@@tal2939 it was an easy surgery.nothing to worry about it.very fast recovery time!
Your born with it, how did you get it in an accident
Hola, me el doctor me acaba de decir que lo que tengo en mis huesos es (MHE) pensé que estaba sola en esto .
Mi padre, mis hermanos , yo y mis hijos tenemos (MHE) Alguien de ustedes sabe si hay algún tratamiento para no heredarlo a futuras generaciones?
Генная инженерия.
ЭКО
Обратитесь к генетику за консультацией😊
Мы должны предотвратит такое размножение! Чтобы не мучить детей 🥺🙏🏻☀️🤗 всё будет хорошо 😊
Ty
saad,
hi
if you have fibrinoid degen.without tear neither partial(50%) nor. complete..you may do will with ph.therapy active assisted and medications.+-platelet rich plasma PRP local injection.
or you may have other reasons indicated for arthroscopy..labral slap
Thanks for nice helpful video
Schmorl's node?
Goodevening sir, I have a painless hard pea shaped bump on top of my knee may I know what is wrong with my right knee..confused and scared..Pls help
I have this on my knee too.
I am too really confused about this, and probably gonna get surgery to hopefuly get rid of it. It is painless, but after and some times during high intensity training it hurts. Go see a doctor asap, i thought it wouldn't bother me, but now i regret not getting surgery earlier. Best of luck to you, hope it gets better!
Это не опасно, но если мешает операция 😔
I got this on my tibia
I have it in my chest on the third right rib
I just had surgery to remove a osteochondroma
Daniel Oconnell aww you’re lucky surgery isn’t necessary right now for me :/
why is it that it isn't necessary yet. isn't that at good one?
Daniel Oconnell how did it go?
I'm I one coming up bc I have MHE to
Was it cancerous?
I'm glad I'm not alone. I have MHE, I been bullied cuz of it
И у меня 😓
If somebody could let me know. Because I’m a young kid and hate surgery. I’m also scared of having it done. I have this in the left leg. Is it a tough surgery?
I have it too, in my left leg right next to my kneecap... You get it removed yet?
Yep, got it removed back in August 2019. Being 12 at the time it was scary but it was quick. You don’t feel sick and your not in much pain. You can’t walk well for the first week or so. You will still be able to run, play etc again!
Totally worth it, and the scar looks sick! No need to worry my friend.
Another thing is that you will have a cast like bandage for the first 24 hours. After you can remove it but you will have surgical tape to remove 10 days after the surgery.
@@tylercinematics thanks man. Glad it healed up for you
Multiple hereditary osteochondromas
Hi aslo have MHE I aslo thought I was alone
У меня такое
Привет! Вступай в группу вконтакте "экзостозная болезнь", там много полезной информации.
Ооо ребята! Ещё актуально?
У меня тоже🥺 хочу найти похожих 😞
Добрый вечер. Мне 17 и у меня это заболевание от отца. А у отца от деда. У меня 2 тип и их очень много. Я удалила уже 3.. мой рост завершён и мне разрешили. Я маленькая 153 уверенна из-за этих шишек, родители высокие ведь. Их много, колени, руки, ключицы.. ребра.. пальцы..
Это так бесит😖 остаются шрамы и боль, но и с ними очень сложно носить юбки, платья, облегающие джинсы.. И многие тебя просто не понимают😞 а лечение стоит очень дорого, потому что в государственных клиниках нет качественного лечения. и они говорят, то что мешает жизни, а не эстетика, а что это мешает моральному здоровью сильно это нормально)))😐
С этим очень трудно..
Но я не одна, у меня есть такая же сестра близнец..😔
Я вполне красива, но шишки портят всю картину и напрочь убивают самооценку..😞 и они очень не приятные, особенно если удариться 💀
Я с восторгом и слезами смотрю на здоровых ровных людей..🥺😭 (поэтому цените и любите своё тело каким бы "толстым или худым, не идеальным" оно ни было. Оно ровное, а так спорт в помощь! Меньше отговорок!
Надеюсь все будет хорошо..
Люди с таким же диагнозом, я понимаю вас. 🥺😓. Об этом надо говорить, это нормально, нас не надо бояться.
Я тоже пытаюсь принять своё тело, и то, что оно не будет таким ровным и красивым как у обычного человека.. но надеюсь операции смогут мне помочь улучшить картину..🥺. 🌷
☀️
Подскажите, пожалуйста, как ваши остеохондромы? Легкие ли операции по их удалению? Есть ли боль после операции? Какого они к вам размера? У племянника 14 лет над коленом такая шишечка с перепелиное яйцо. Очень переживаем. Как думаете, нужно ли удалять? Или можно просто наблюдать?
@@user-tm1dj9fx8h нужно найти хорошего врача. И желательно в частной клиники. Потому что в Государатанных, безолаберно остаются просто огромные шрамы и спайки!
У меня тоже есть такой экзостоз над коленом, он тоже очень не приятный. Пока не удаляла. Если сильно не мешает, то лучше пока наблюдать. А потом думаю без проблем можно будет удалить.
После любой операции присутствует боль. Это считается нормой. Шов срастётся и нужно будет разрабатывать, разминать шрам, чтобы не было спаек, это очень не приятно. Потом можно дальше всем заниматься.
Операции вполне популярны такие. Советуют после 18 или когда костный рост будет закрыт. Но врачи говорят, что можно не удалять и так жить если не мешает) у меня разные размеры. Есть маленькие на пальце. Есть прям большие чуть больше перепелиного яйца. Больше мешают эстетически..
@@user-tm1dj9fx8h наблюдайте. Если будет мешать, потом легко удалить. (Найдите хорошего врача и желательно дождаться 18 лет) останется глубокий шрам, потом нужна с ним работа, растяжка, от спаек.
Это не страшно. Может болеть первое время, потом забивает. Шрам ощущается неприятно (они глубокие и думаю так у всех.)
Если не мешает, лучше вообще не трогать😌
(Я уже отвечала, но моего сообщения почему-то тут нет.. 😕 поэтому ответила ещë раз 🤗 будьте здоровы🌷
@@user-tm1dj9fx8h у меня точно такой же над коленом. Мне мешает и эстетически и при занятии спортом. Планирую удалять.. 🥺
Несколько операций было, это не очень страшно.
@@Marina-ji6nx спасибо вам большое за ответ. Надеюсь, операция пройдет удачно. Подскажите, пожалуйста, в каком возрасте вы начали их удалять? Это очень больно?
Im 43yrs old, had an x-Ray because I have had knee pain on and off for the past year thinking it was arthritis. Was just told from my Dr that the x-Ray is showing that it looks like osteochondroma. Can an x-Ray confirm the diagnosis?
Not sure I’m 41 had a ATV accident 3 weeks ago dislocated my hip and fractured my femur head bone when they did the CT scan they saw I had a ostrochondroma behind my knee 😢 I had never had any kind of pain. Now that I know about it I feel like it bothers me no idk if it’s because I know about it or because of my accident