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Introduction: Osteochondromas, also known as osteocartilaginous exostosis, are among the most common benign cartilaginous bone tumors, primarily occurring as solitary lesions. While typically found in long bones, spinal involvement is rare, accounting for only a small percentage of benign lesions in this location. Solitary osteochondromas responsible for spinal cord compression are seldom., Case Presentation: We describe the case of a 34-year-old male with no significant medical history, presenting with progressive symptoms suggestive of spinal cord compression. Imaging studies revealed a bony lesion originating from the left lateral aspect of the posterior arch of the T8 vertebra, causing spinal cord compression and myelopathy. Surgical intervention was necessary to decompress the spinal cord and obtain histological samples, resulting in immediate postoperative improvement in motor function. Pathologic exam concluded to an osteochondroma., Discussion: Osteochondromas primarily affect growing bones and are more commonly observed as solitary lesions, particularly in male patients. Spinal involvement is rare, and neurological symptoms are typically indicative of intracanalar extension of the exostosis, leading to compression of neural elements. Imaging modalities such as MRI are crucial for assessing cartilage thickness and the impact of compression on the spinal cord., (© 2024. The Author(s), under exclusive licence to International Spinal Cord Society.)

Objective: To describe the diagnosis, management, and outcome of a dog with a right distal radial osteochondroma that penetrated the ulna, causing expansile lysis and fracture., Animal: A 9-month-old entire female German Shorthaired Pointer., Clinical Presentation, Progression, and Procedures: The dog had a 2-month history of weight-bearing lameness of the right forelimb and a 2-week history of a progressively enlarging, firm swelling on the distolateral antebrachium. Computed tomography was used to characterize the lesion and for surgical planning., Treatment and Outcome: A distal ulnar ostectomy removed the affected ulnar segment, and the radial osteochondroma was excised with rongeurs. The dog was sound at 2, 16, and 45 weeks postoperatively. Radiographs at 45 weeks showed a persistent ulnar ostectomy gap with irregular but smoothly marginated edges and focal cortical irregularity at the site of radial osteochondroma excision. There was no evidence of osteochondroma recurrence., Clinical Relevance: This is a newly recognized presentation of an osteochondroma penetrating the cortex of an adjacent bone in a dog resulting in expansile lysis and cortical fracture. Computed tomography was important in diagnosis and surgical planning, and surgical treatment was successful in removing the osteochondroma and ulnar lesion. This case provides long-term radiographic and clinical follow-up after osteochondroma excision and contributes to the current knowledge on prognosis following osteochondroma excision in dogs.

Case: We report a unique case of dynamic scapular winging due to compression of the long thoracic nerve by a ventral scapular osteochondroma, representing a combination of mechanical and neural causes. Arthroscopic resection of the lesion was performed, which led to complete resolution of the symptoms., Conclusion: By reporting this case, we aimed to increase awareness of the importance of a correct etiological diagnosis of dynamic scapular winging, so that targeted treatment can be addressed. Arthroscopic resection seems ideal for this indication because it reduces the risk of complications and patient recovery time., Competing Interests: Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSCC/C411)., (Copyright © 2024 by The Journal of Bone and Joint Surgery, Incorporated.)

Background: This study aimed to demonstrate the occurrence of lower extremity deformities and their risk factors in patients with solitary osteochondromas., Methods: We retrospectively reviewed consecutive patients with solitary osteochondromas around the knee. The laterality (left or right), involved bone (femur or tibia), tumor type (pedunculated or sessile), and direction (medial or lateral) were examined. The whole limb length (WLL), mechanical lateral distal femoral angle (mLDFA), and medial proximal tibial angle (MPTA) were measured using teleroentgenogram. Lower limb deformity was defined as a difference of more than 5° in mLDFA or MPTA in both lower extremities or a difference in WLL of more than 1 cm. Patients were divided into two groups, with deformity and without deformity., Results: Lower extremity deformities were observed in 8 of 83 patients. Significant difference in the type of osteochondroma (p = 0.004) between the groups was observed. Differences in sex, age, laterality, involved bone, direction, and distance from the physis to the osteochondroma between groups were not statistically significant. The sessile type of osteochondroma was a risk factor for lower limb deformity with an odds ratio of 24.0 according to Firth's logistic regression analysis., Conclusion: In our cohort with solitary osteochondroma, lower limb deformities were observed in 8 (9.6%) out of the 83 patients and these were significantly associated with sessile-type tumors. Therefore, patients with sessile-type solitary osteochondroma around the knee require careful surveillance of lower limb alignment with whole leg teleroentgenogram., (© 2024. The Author(s).)

Parosteal lipomas and osteochondromas of the head and neck are uncommon benign tumors, constituting a small fraction of lipoma and bone tumor cases. We present a unique case of a 66-year-old male with a parosteal lipoma overlying an osteochondroma in the anterior midline neck, causing dysphagia. Surgical excision confirmed the diagnosis, and a literature review revealed similar cases predominantly adjacent to the mandible or calvaria. This case emphasizes the need to have parosteal lipoma and osteochondroma on the differential diagnosis for patients presenting with a firm mass of the central neck, especially with a history of trauma. Laryngoscope, 134:2844-2847, 2024., (© 2023 The American Laryngological, Rhinological and Otological Society, Inc.)

Although exostosis or osteochondroma is a common bone tumor, associated vascular complications are rare. Clinical and radiological diagnoses are sometimes challenging, and there is no codification for surgical management. We report two cases of popliteal arterial pseudoaneurysms due to osteochondroma of the distal femur. A review of the current literature about case series and case reports of patients affected by arterial pseudoaneurysm complicating osteochondroma was also performed., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Introduction: Alveolar oral exostosis is a common, benign condition routinely found in dentistry. Clinical problems associated with exostoses are the maintenance of oral hygiene as well as the fabrication of prosthodontic appliances. Over time, exostoses may contribute to irritation and periodontal disease., Case Description: The patient in this case study had a recurrence of exostoses and was bothered by consistent and prominent pain. She reported being a bruxer; her bruxism was exacerbated due to attention-deficit hyperactivity disorder and antidepressant medications., Discussion: The etiology behind the recurrence of exostosis is discussed. The most evident etiology seems to be persistence of medication-induced bruxism, specifically awake bruxism., Conclusion: It is necessary to take a proper history to identify the cause of the recurrence of exostosis. Dental hygienists can contribute to a better understanding of and provide better treatment options for patients who have medication-induced bruxism., Competing Interests: The authors report no conflicts of interest., (Copyright © 2024 CDHA | ACHD.)

Competing Interests: Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

Case: A 19-year-old man with Multiple Hereditary Exostoses presented with cervical pain without neurological symptoms and/or signs. Magnetic resonance revealed a large C2 osteochondroma, occupying a part of the medullary canal. He was submitted to an en bloc resection with hemilaminectomy without fusion. At the 1-year follow-up, he presented resolution of pain and no neurological symptoms or signs, without cervical instability or radiological signs of disease recurrence., Conclusion: Cervical osteochondroma is usually asymptomatic. Neurological compression and differentiation to chondrosarcoma are the main concerns. Surgical excision allows the local cure of the disease and is usually performed without fusion., Competing Interests: Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSCC/C276)., (Copyright © 2024 by The Journal of Bone and Joint Surgery, Incorporated.)

Trigger finger is usually caused by stenosing tenosynovitis and hypertrophy of the retinacular sheath, and the most common site of tendon triggering is the A1 pulley. Although the A3 pulley trigger finger has been described in a few cases caused by hypertrophy of the retinacular sheath and ganglion, associated skin findings have not been reported to date. Herein, we report a rare case of the A3 pulley trigger finger due to osteochondroma with unique skin findings in a 50-year-old woman. In this case, we observed a V-shaped skin depression on the palmar side of the proximal interphalangeal joint of the right middle finger during finger locking. Additionally, we observed bilateral linear skin depressions on the sides of the proximal phalange. These findings might be caused by the traction force on the A3 pulley, connected to the skin via the Grayson and Cleland ligaments, which are fibrous tissues that connect the skin and tendon sheath.

Rationale: Osteochondroma is one of the most common primary benign bone tumors. In most cases, this disease is asymptomatic. However, it may become symptomatic owing to nerve and vascular compression when it affects the knee joint. Isolated tibial nerve palsy caused by proximal fibular osteochondroma is rare., Patients Concerns: A 60-year-old male, was treated for degenerative arthritis of the right knee, referred to the right great toe flexion limitation that occurred 3 weeks prior., Diagnoses: Magnetic resonance imaging revealed compression of the tibial nerve and surrounding muscles due to an osseous lesion in the fibular head. A nerve conduction test confirmed tibial neuropathy in the right lower leg., Interventions: Exploratory surgery was performed to decompress the tibial nerve and remove the bony lesion histopathologically diagnosed as an osteochondroma., Outcomes: Fifty-five months postoperatively, toe flexion recovered to normal. No recurrence of osteochondroma was observed., Lessons: As in our case, if a bony lesion is diagnosed on radiographs with neurological symptoms, early decompression surgery is necessary. Moreover, since it can be misdiagnosed as a simple bony spur, magnetic resonance imaging and tissue biopsy are also indicated., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

Osteochondromas account for 20%-50% of all benign bone lesions. These tumors may present as solitary non-hereditary lesions, which are the most common presentation, or as multiple tumors associated with hereditary conditions. Plain radiography is the imaging method of choice and demonstrates the typical cortical and medullary continuity of the tumor with the underlying bone. Magnetic resonance imaging is often performed to evaluate cartilage cap thickness, which correlates with malignant transformation. Other local complications include compression of adjacent neurovascular bundles, muscles, and tendons, bursitis, tendon tears, stalk fracture, and angular or rotational long bone deformities. Although the imaging features of osteochondromas are largely known, only a few papers in the literature have focused on their main complications and image-based follow-up. This paper aimed to illustrate the main complications of osteochondromas, suggest an image-based algorithm for management and follow-up and discuss differential diagnosis., Competing Interests: Declaration of competing interest The authors have no conflict of interest to disclose., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Peripheral nerve injuries due to mass effect from bony lesions can occur when the nerve exists in an anatomically constrained location, such as the common peroneal nerve at the fibular head which passes into the tight fascia of the lateral leg compartment. We report a case of a pediatric patient who developed a common peroneal nerve palsy secondary to an osteochondroma of the fibular head and describe the clinical evaluation, radiographic findings, and surgical approach. Rapid diagnosis and nerve decompression after the onset of symptoms restored full motor function at the 8-month postoperative mark., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Orthopaedic Surgeons.)

Many options exist in the diagnosis and management of condylar osteochondroma. The purpose of this study was to provide a congregate information concerning treatment of the osteochondroma involving the mandibular condyle. The search was conducted in PubMed, Google Scholar, Semantic Scholar, and Cochrane database until February 2022. Twenty-seven studies were included for the final review. The review included 439 patients who underwent surgical management for mandibular condylar osteochondroma. The position of osteochondroma was mentioned in 13 studies. Preauricular, retromandibular, endaural, submandibular, transzygomatic, and intraoral approaches were used for approaching the tumor. Surgical techniques included resection, conservative condylectomy, and total condylectomy. Concomitant orthognathic surgery was performed along with tumor resection in 19 studies. In the entire review, the recurrence rate was 0.22% (1/439). The results of the meta-analysis showed that 2 studies reported significant malocclusion events after surgical therapy. Total joint replacement after tumor resection has a higher improvement in maximal mouth opening (8 mm) compared with vertical ramus osteotomy and no reconstruction groups, which have similar improvements (6 mm). The mainstay of treatment of osteochondroma is surgical excision either as condylectomy or conservative condylectomy. Among the various reconstruction modalities, total joint replacement showed better improvement in mouth opening. Adjunct procedures like orthodontic and orthognathic surgery have an important role in holistic management of severe cases. The treating surgeon must choose the surgical procedures in a pragmatic way., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Osteochondromas are the most common benign bony tumour, usually occurring in the 2nd/3rd decade of life and generally asymptomatic. However, there have been reports of bony tumours causing arterial vascular injuries via erosion into vessel walls. We present a case of a 16-year-old M with no significant past medical history who presented with acute-on-chronic Right Lower Extremity (RLE) pain and numbness who was found to have a popliteal artery pseudoaneurysm and occlusion. We will discuss our initial work up, management, outcomes and follow up and compared our results with an English language literature search for comparable cases.

The aim of the study was to describe an approach where condylar resection with condylar neck preservation was combined with Le Fort I osteotomy and unilateral mandibular sagittal split ramus osteotomy (SSRO). Patients with a unilateral condylar osteochondroma combined with dentofacial deformity and facial asymmetry who underwent surgery between January 2020 and December 2020 were enrolled. The operation included condylar resection, Le Fort I osteotomy and contralateral mandibular sagittal split ramus osteotomy (SSRO). Simplant Pro 11.04 software was used to reconstruct and measure the preoperative and postoperative craniomaxillofacial CT images. The deviation and rotation of the mandible, change in the occlusal plane, position of the "new condyle" and facial symmetry were compared and evaluated during follow-up. Three patients were included in the present study. The patients were followed up for 9.6 months on average (range, 8-12). Immediate postoperative CT images showed that the mandible deviation and rotation and occlusion plane canting decreased significantly postoperatively; facial symmetry was improved but still compromised. During the follow-up, the mandible gradually rotated to the affected side, the position of the "new condyle" moved further inside toward the fossa, and both the mandible rotation and facial symmetry were more significantly improved. Within the limitations of the study it seems that for some patients a combination of condylectomy with condylar neck preservation and unilateral mandibular SSRO can be effective in achieving facial symmetry., Competing Interests: Declaration of competing interest The authors have no conflicts of interest to declare., (Copyright © 2023 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

Background: The spontaneous regression of osteochondromas is rare, and only a few cases have been reported. Furthermore, the precise mechanism underlying spontaneous regression is unknown. This study aimed to examine the radiological findings of osteochondromas that had spontaneous regression and to identify potential indicators of this uncommon phenomenon in skeletally immature patients with osteochondromas., Methods: We included 28 patients (15 males and 13 females) who met the eligibility criteria between 2002 and 2019. The mean age at initial diagnosis was 9.7 years old (2-16 years). The mean follow-up period was 6.4 years (3-16 years)., Results: Of the 28 patients, 10 (35.7%) had osteochondroma resolution. The osteochondroma resolved in one patient and regressed in nine. Tumor shrinkage is related to the thickness of the cartilage cap. The thickness of the cartilage cap did not correlate with age., Conclusions: Tumor shrinkage is associated with a thinner cartilage cap on magnetic resonance imaging. The thickness of the cartilage cap may be an important predictor of spontaneous regression in pediatric patients with osteochondroma.

Background: While most cases of sciatica result from degenerative conditions of the low back, some cases result from conditions of the hip and pelvic region. Sciatica developing in relation to pregnancy or labor also presents unique considerations., Case Presentation: A 37-year-old African American woman with a history of hypertension and polycystic ovary syndrome presented to a chiropractor at a hospital-based outpatient clinic with a seven-week history of low back pain with radiation into the right lower extremity which began during labor. The chiropractor performed a brief trial of care, yet when the patient's symptoms worsened, ordered lumbar spine radiographs, followed by lumbar magnetic resonance imaging (MRI), which were both normal. The chiropractor then ordered hip radiographs, which were suggestive of ischial osteochondroma, and referred the patient to an orthopedic oncologist. MRI findings were compatible with an osteochondroma with associated adventitial bursitis and mass effect on the sciatic nerve. The patient initially chose conservative management with bursa aspiration and therapeutic injection. Despite initial relief, there was eventual return of symptoms. The patient elected to undergo surgical removal, with a positive outcome., Conclusion: The key distinguishing features that led to a diagnosis of osteochondroma in this case included attention to the patient-reported symptoms and history, worsening of symptoms despite conservative care, and lack of explanatory findings on lumbar imaging. This case highlights the benefit of evaluating the hip and pelvis when the clinical features of sciatica cannot be ascribed to a lumbar etiology. This case also illustrates the role of a chiropractor working in an integrative health system to facilitate timely imaging and referrals to resolve a challenging diagnosis., (© 2022. The Author(s).)

Purpose: The present study aimed to investigate the clinical efficacy of simultaneous management of condylar osteochondroma and its secondary dentofacial deformities using an intraoral surgical approach., Methods: Six patients with condylar osteochondroma were treated with intraoral vertical ramus osteotomies and condylar resection. The free rising branch was used for reconstructing the temporomandibular joint. The simultaneous orthognathic surgery and plastic surgery were performed sequentially to correct the secondary dentofacial deformities. The indexes of aesthetic symmetry, occlusion relationship, temporomandibular joint function, condylar height, and volume change were assessed in the subsequential follow up., Results: The mean follow up period was 31 months. All patients had no tumor recurrence. The ipsilateral joint function, occlusal relationship, and facial symmetry were satisfied. The ipsilateral condylar reconstruction had no obvious bone resorption and the ramus height was maintained well. Postoperative assessment showed the preoperative design was accurately fulfilled., Conclusions: The simultaneous condylar osteochondroma resection and temporomandibular joint reconstruction using intraoral approach avoids extraoral scars and correct facial asymmetry without compromising the long-term joint function and occlusal relationship., Competing Interests: The authors report no conflicts of interest., (Copyright © 2022 by Mutaz B. Habal, MD.)

Background: Osteochondromas, also known as exostoses, are the most common benign tumors of bone and can be classified into isolated and multiple osteochondromas. A great majority of osteochondromas is asymptomatic, painless, slow-growing mass, and incidentally found. However, osteochondromas occurring in adolescence or in adult patients can grow in size and become symptomatic as a result of mechanical irritation of the surrounding soft tissues or peripheral nerves, spinal cord compression, or vascular injury., Case Presentation: We present a case of a 13-year-old girl with spontaneous hemothorax, the cause of which was identified by limited thoracotomy with the aid of video-assisted thoracic surgery to be bleeding from a diaphragmatic laceration incurred by a costal exostosis on the left sixth rib. Preoperative chest computed tomography (CT) depicted a bony projection arising from the rib and bloody effusion in the intrathoracic cavity, but was unable to discern the bleeding cause from the lung or the diaphragm. This case will highlight our awareness that costal exostosis possibly results in bloody pleural effusion. Meanwhile, English literatures about solitary costal exostosis associated with hemothorax were searched in PubMed and nineteen case reports were obtained. Combined our present case with available literature, a comprehensive understanding of this rare disease entity will further be strengthened., Conclusions: Injury to the diaphragm is the primary cause of hemothorax caused by costal osteochondroma, including the present case. Thoracic CT scan can help establish a diagnosis of preoperative diagnosis of costal osteochondroma. Surgical intervention should be considered for those patients with symptomatic osteochondroma of the rib. Combined with our case and literature, prophylactic surgical removal of intrathoracic exostosis should be advocated even in asymptomatic patients with the presentation of an inward bony spiculation., (© 2022. The Author(s).)

Purpose: The purpose of this study was to determine imaging features of reactive bursitis secondary to osteochondroma., Materials and Methods: Fourteen patients with reactive bursitis secondary to osteochondroma were retrospectively reviewed., Results: The 14 patients were 11 males and 3 females ranging in age from 18 to 67 years (mean, 33.6 years). The locations were as follows: scapula (n = 2), lesser trochanter (n = 6), greater trochanter (n = 1), distal femur (n = 2), distal fibula (n = 1), iliac bone (n = 2). On CT, six bursae were hypodense and 1 was isodense compared to muscle. All bursae had a thickened wall, 6 contained multiple villous projections and septa. Five bursae contained a few calcifications. On enhanced CT, the bursa displayed mild enhancement of the wall, villous projections, and septa. On MRI, one bursa was hypointense, three were hyperintense, and 5 were isointense relative to muscles on T1-weighted images. All bursae were hyperintense relative to muscles on T2-weighted images. All bursae had a thickened wall, eight contained multiple villous projections and septa. In five bursae, a few fatty villous projections can be seen within the bursa. On enhanced MRI, all bursae displayed avid enhancement of the bursal wall, villous projections, and septa., Conclusions: Reactive bursitis secondary to osteochondroma most often occurred in young male adults. The most common involved site is lesser trochanter. The imaging features is that of an irregular, thick-walled fluid-filled bursa overlying an osteochondroma that containing multiple villous projections and septa. Calcification and/or lipoma arborescens may be developed within the bursa. On contrast-enhanced images, the bursa shows enhancement of the bursal wall, villous projections and septa., (© 2022. The Author(s) under exclusive licence to Japan Radiological Society.)

Purpose: To investigate current Computer-Aided Design and Computer-Aided Manufacturing (CAD/CAM) technologies applied in the treatment of dentofacial deformities secondary to condylar osteochondroma and introduce a modified method with additional pre-bent titanium miniplates to improve the accuracy of operation., Methods: Literature review about the application of CAD/CAM in the treatment of condylar osteochondroma and secondary dentofacial deformities was conducted. And 8 patients with condylar osteochondroma and secondary dentofacial deformities were treated by the CAD/CAM cutting and drilling surgical guides as well as pre-bent titanium miniplates. Pre- and post-operative 3D-cephalometric measurement were recorded and the difference between virtual simulation and postoperative modeling images was measured. Follow-up and radiographic examinations were performed., Results: A total of 17 studies (including 216 patients) about the application of CAD/CAM in the treatment of dentofacial deformities secondary to condylar osteochondroma have been reported since 2010, including the 8 present patients. In our study, all patients were satisfied with the surgical outcome, without obvious relapse or evidence of temporomandibular joint disorder or other complications during follow-up; all patients avoided condylar reconstruction and sagittal split of ramus osteotomy on the ipsilateral mandible side. Comparison between simulated plans and actual postoperative outcomes showed surgical simulation plan was accurately transferred to the actual surgery., Conclusions: The application of CAD/CAM cutting and drilling guides as well as pre-bent titanium plates could achieve more accurate and favorable outcomes, improving the clinical planning and surgical execution for patients with condylar osteochondroma and secondary dentofacial deformities., Competing Interests: The authors report no conflicts of interest., (Copyright © 2021 by Mutaz B. Habal, MD.)

Background: Neurogenic thoracic outlet syndrome typically presents with paresthesia, pain, and impaired strength in the neck, shoulder, and arm, and is typically a diagnosis of exclusion. This condition is caused by compression of the brachial plexus, typically by a bony or soft tissue anomaly present congenitally and influenced by repetitive motion or significant trauma. Treatment typically involves removal of the first rib and anterior scalene to decompress the thoracic outlet and relieve stress to the brachial plexus if the patient has failed conservative treatment with physical therapy and lifestyle modifications. Case Presentation: We present a case of neurogenic thoracic outlet syndrome with arterial compression treated surgically via a transaxillary first rib and cervical rib resection in a patient with bilateral cervical ribs and osteochondromas of the ribs.

Background and Objective: Osteochondroma is the most frequent benign bone tumor, it can present in solitary or multiple form. Only 1 to 4% of osteochondromas are found in the spine and the most frequent of these is located at the cervical level. Of all spinal osteochondromas, only 0.5% develop insidious and progressive symptoms of medullary compression, either in the form of myelopathy or radiculopathy. These tumors do not grow once the bone maturation is complete, so if the clinic appears, it does so mainly in young patients, between 20 and 30 years old., Methodology: young male with asymptomatic one year evolution posterior cervical tumor, that begins with cervicalgia and interscapular pain, without alarm symptoms. Surgical resection of the tumor is decided., Results: the pathological result describes the tumor as an osteochondroma. Six months after the intervention, the patient did not report cervicalgia or interscapular pain with a good state of scarring and cervical mobility., Conclusion: Regarding the management of these tumors, surgical treatment, by means of their resection, is indicated, if the patients present symptoms, with good functional results and a low number of complications. Its management in asymptomatic cases is controversial., (Universidad Nacional de Córdoba.)

Background: Various factors are discovered in the development of clinodactyly. The purpose of this retrospective study was to present a group of children with a rare clinodactyly deformity caused by phalangeal intra-articular osteochondroma and evaluate the efficacy of various treatment methods., Methods: All child patients that were treated for finger problems in our center between Jan 2017 and Dec 2020 were reviewed. A detailed analysis was made of the diagnosis and treatment methods in eight rare cases. X-rays and histopathology were applied., Results: A preliminary analysis of 405 patients in total was performed, and we included eight cases in our final analysis. This cohort consisted of 2 girls and 6 boys, with a mean age of 5.74 ± 3.22 years (range: 2y5m to 11y). Overall, four patients had their right hand affected and four patients had their left hand affected. One patient was diagnosed as having hereditary multiple osteochondroma (HMO) while the other seven patients were all grouped into solitary osteochondroma. Osteochondroma was proven in all of them by histopathology examination. Preoperative X-rays were used to allow identification and surgery planning in all cases. All osteochondromas were intra-articular and in the distal end of the phalanges, which is located opposite the epiphyseal growth area. All of the osteochondromas developed in half side of the phalanges. The angulation in the finger long axis was measured, and resulted in a mean angulation of 34.63 ± 24.93 degree (range: 10.16-88.91 degree). All of them received surgery, resulting in good appearance and fingers straightening. No recurrence was recorded., Conclusions: This retrospective analysis indicates that 10 degrees can be selected as the angulation level for diagnosis of clinodactyly deformities. What's more important, the abnormal mass proven by X-rays should be included as the classical direct sign for diagnosis. The first choice of treatment is surgery in symptomatic osteochondromas., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Hao, Guo, Wang, Shao, Feng and He.)

Background: Osteochondroma is the most common benign bone neoplasm and is sometimes referred to as osteocartilaginous exostosis. The symptoms caused by osteochondroma are rare, especially the urogenital complications. Therefore, this tumour is sometimes misdiagnosed., Case Presentation: This report described a 70-year-old woman with hematuria who was initially misdiagnosed with a bladder tumour in the outpatient department by a urologist. However, during cystoscopy, we found that the mass did not resemble a bladder tumor. Multidisciplinary approach with careful analysis of the imaging data suggested the diagnosis of osteochondroma. Open surgical excision of the mass was done and histology confirmed the diagnosis of benign osteochondroma. After 6 months of follow-up, the patient was still asymptomatic., Conclusions: This case illustrates that hematuria is caused by not only urogenital disease but also osteochondroma. We present this case to draw the attention of clinicians to osteochondroma of the pubic symphysis.

Context: Osteochondroma is the most common benign tumor of the bone, but spinal osteochondroma is rare. We report a case of cervical osteochondroma in multiple exostoses arising from the lamina of the C2 vertebra, presenting with features of compressive myelopathy in a 22-year-old male. Total resection of the tumor and atlantoaxial fixation and fusion after reconstruction of the C1 posterior arch were performed. Findings: The patient recovered significantly. He was asymptomatic and no sign of recurrence was observed after one-year follow-up. Conclusions: Osteochondroma should be considered as a rare cause of spinal cord compression. Entire removal of the tumor will result in complete decompression and can reduce the risk of recurrence. We provide a new approach to reconstruct after resection.

Spinal osteochondromas are very rare, and they present with nonspecific localized pain owing to bone involvement. Diagnosis is made based on direct X-ray and computed tomography (CT) imaging of the exophytic bone lesion with pedunculated or sessile structure. Although asymptomatic patients can be observed, surgical excision is the main treatment modality. We present the case of a 34-year-old man with solitary thoracic osteochondroma. The patient presented with complaints of pain in the legs, numbness, and inability to walk. The diagnosis was confirmed with CT imaging showing calcified heterogeneous bone lesion originating from the left side of T1-2 facet joint. After total excision, histopathological examination revealed the diagnosis of osteochondroma. No new clinical or radiological findings were detected in the 10-month follow-up.

Osteochondroma of the talus is a rare entity that can cause pain, swelling, restriction of movements, synovitis and tarsal tunnel syndrome (TTS). We present three such cases with varying presentation. Case 1 presented with synovitis of the ankle along with a bifocal origin of the talar osteochondroma. Case 2 presented with TTS as a result of compression of the posterior tibial nerve. Case 3 presented with deformity of the foot. In all the three cases, the mass was excised en bloc and histologically proven to be osteochondroma. In case 3, the ankle joint was reconstructed with plate, bone graft and arthrodesis of the inferior tibiofibular joint. All the three cases had good clinical outcomes., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Osteochondromas (or exostoses) are the most common benign tumors of the bone. Vascular complications of these tumors are rare but have been increasingly reported in recent literature., Aim: Throughout an unusual case report of popliteal artery entrapment syndrome secondary to a femoral osteochondroma, we highlight the necessity of thorough clinical and radiological examinations as well as meticulous and prompt surgical resection., Case Report: A 27-year-old male patient, who had been diagnosed with multiple osteochondromas and had never been operated on, presented with a one-year history of exercise-induced left calf pain, paresthesias of the left leg and pallor in cold weather. After radiographic and Computed Tomography angiographic evaluation, we diagnosed distal femur osteochondroma associated with an arterial compression of the left popliteal artery. A surgical treatment of all lesions was performed. No operative complications occurred. The pain was relieved. Good postoperative results have been noticed., Conclusion: Popliteal aretery entrapment syndrome may be caused by solitary or multiple osteochondromas around the knee. Therefore, prophylactic resection of exostoses in the surrounding area of a vessel should be performed. Moreover, the orthopedic surgeon should consider and prevent vascular complications during surgical resection of knee osteochondromas.

Trigger finger is stenosing tenosynovitis that occurs in A1 pulley. It usually occurs idiopathically in patients' 40s and 50s. On the other hand, pediatric trigger finger usually occurs before 8 years old in pediatric patients. Even though being rare, a tumor occurred in the soft tissue or bone near flexor tendons can cause a trigger finger. Trigger finger due to osteochondroma is very rare. Furthermore, most cases of trigger finger due to osteochondroma occur in pediatric patients with hereditary multiple osteochondromatosis (HMO). The authors report this case of a trigger finger caused by a solitary osteochondroma that occurred in the proximal portion of the proximal phalanx of the left middle finger, of a 21-year-old patient. The symptoms were relieved after excision of the osteochondroma. If a patient with unusual demographics visits, the cause of trigger finger may not be idiopathic. Evaluation methods such as x-rays and ultrasonography can be helpful to rule out other causes, such as tumors.

Aim: To provide a diagnostic approach to distinguish osteochondroma-induced pseudoaneurysm from sarcoma on imaging and prevent biopsy which may be fatal., Materials and Methods: A retrospective study of the orthopaedic oncology database was performed to identify all patients referred to specialist orthopaedic oncology service with a final diagnosis of osteochondroma-induced pseudoaneurysm. The demographics of the cohort, the anatomical location of the osteochondromas and pseudoaneurysms, and the imaging appearances were assessed., Results: Seven contemporary and one historical case of osteochondroma-induced-pseudoaneurysm were identified. There were five patients with solitary osteochondroma and three cases of hereditary multiple exostosis. Five cases underwent magnetic resonance imaging (MRI) of which pulsation artefact was present in 40%. On MRI, all the present cases demonstrated a small central pseudoaneurysm surrounded by multiple eccentric layers of thrombus and haemorrhage, which was termed the "eccentric-whorl sign"., Conclusion: Osteochondroma-induced pseudoaneurysms are often misdiagnosed as malignant transformation of an osteochondroma or a soft-tissue sarcoma and referred for urgent biopsy. This study presents the largest case series, which includes the first documented case diagnosed in 1934. Differentiating and characterising pseudoaneurysms from sarcomas is imperative in order to prevent a biopsy, which could be fatal., (Copyright © 2020 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.)

Background: Tarsal tunnel syndrome is an entrapment neuropathy that can be provoked by either intrinsic or extrinsic factors that compresses the posterior tibial nerve beneath the flexor retinaculum. Osteochondroma, the most common benign bone tumor, seldom occur in foot or ankle. This is a rare case of tarsal tunnel syndrome secondary to osteochondroma of the sustentaculum tali successfully treated with open surgical excision., Case Presentation: A 15-year-old male presented with the main complaint of burning pain and paresthesia on the medial plantar aspect of the forefoot to the middle foot region. Hard mass-like lesion was palpated on the posteroinferior aspect of the medial malleolus. On the radiological examination, 2.5 × 1 cm sized bony protuberance was found below the sustentaculum tali. Surgical decompression of the posterior tibial nerve was performed by complete excision of the bony mass connected to the sustentaculum tali. The excised mass was diagnosed to be osteochondroma on the histologic examination. After surgery, the pain was relieved immediately and hypoesthesia disappeared 3 months postoperatively. Physical examination and radiographic examination at 2-year follow up revealed that tarsal tunnel was completely decompressed without any evidence of complication or recurrence., Conclusions: As for tarsal tunnel syndrome secondary to the identifiable space occupying structure with a distinct neurologic symptom, we suggest complete surgical excision of the causative structure in an effort to effectively relieve symptoms and prevent recurrence.

Although osteochondroma is a benign bone tumor often observed in daily practice, solitary osteochondroma of the bicipital tuberosity is rarely observed. Herein, we report a case of bilateral solitary osteochondroma of the bicipital tuberosity. A 76-year-old woman experienced crackling and painful clicking bilaterally in her proximal forearms during pronation-supination. X-ray imaging, computed tomography, and magnetic resonance imaging revealed that the symptom was caused by bilateral solitary osteochondroma of the bicipital tuberosity. Bone tumor resection was performed on both sides. After surgery, the symptoms improved. X-ray imaging performed 2 years after surgery revealed no tumor recurrence. When painful clicking occurs around the elbow joint, a solitary osteochondroma of the bicipital tuberosity should be suspected; this symptom should be examined, and the surgeon should consider surgery positively. Exposed subchondral bone may rub against, collide with, or impinge upon the ulna during forearm pronation-supination and induce pain.

Progressive unilateral knee stiffness is an uncommon complaint in older adult. Tumor and specific infection should be considered in addition to osteoarthritis. We report a case of intracapsular and paraarticular chondroma in the infrapatellar Hoffa's fat pad that presented as a painless limited knee in 64-year old man. A physical examination revealed a firm, movable mass in the infrapatellar area. Radiographs and Magnetic resonance images showed an ovoid, well-defined, soft tissue mass with focal calcification in the infrapatellar fat pad. The mass was completely resected surgically through a medial parapatellar approach. The final pathology revealed an intracapsular and paraarticular chondroma. At follow-up, 3 years after the operation, patient was pain-free, with complete recovery of the range of motion of the knee and without any clinical or radiographic evidence of recurrence. Intracapsular and paraarticular chondroma is a rare benign lesion of the large joints (mostly the knee). The Pathogenesis of these tumours is controversial. The diagnosis is made with correlation of clinical, radiological and histological features. The treatment of choice is surgical excision.