OSTEOCHONDROMA

Osteochondroma is a growth of cartilage and bone at the end of a bone, near the growth plate. It most often affects long bones in the leg, pelvis, or shoulder blade. Osteochondroma is the most common noncancerous bone growth.

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Osteochondroma

An osteochondroma is a noncancerous development of bone and cartilage. (The terms “osteo,” “chondro,” and “oma” all refer to the bone, respectively.) The majority of benign bone tumors in children are Osteochondromas. When children and teenagers grow in height and stature, new bone forms towards the ends of long bones. This disc of forming cartilage tissue called the growth plate eventually becomes bone. Osteochondroma is a growth plate aberrant protrusion. It begins to grow during childhood and often ceases when the skeleton finishes expanding.

Solitary Osteochondroma

A single osteochondroma is considered the most frequent benign bone tumor and accounts for 35% to 40% of benign bone tumors. When a bone extends from a growth plate as opposed to aligning with it, a single osteochondroma may develop as the child develops. These benign tumors are most common where long bones meet joints, such as knees, hips, and shoulders. An isolated osteochondroma might have a stalk or stem that protrudes from the surrounding bone. Sessile tumors are those that adhere to the bone and have a wide base.

Which Osteochondroma Varieties Exist?

Osteochondroma occurs in two forms: single growth or multiple growths. These are considered two different conditions.

Solitary Osteochondroma

The most frequent kind of osteochondroma is solitary. There are frequently no symptoms associated with a single solitary osteochondroma. When analyzing imaging for another ailment, your healthcare professional can unintentionally come upon an osteochondroma. It does not invade other bodily regions since it is not malignant. The cause is obscure. Analysts suspect that osteochondromas may come from a patient’s parent’s genes.

Multiple Osteochondromas

Multiple osteochondromas occur in approximately 15% of cases. These growths are usually the result of genetically inherited conditions from the child’s parents. However, it can also occur randomly (approximately 30% chance). The genetic disease is called hereditary multiple osteochondromas or hereditary multiple exostoses (exostosis is an external bone growth). Multiple osteochondromas are also noncancerous but usually increase the risk of complications by interfering with normal bone growth.

QUESTIONS AND ANSWERS

What is an osteochondroma, and how does it affect my child's health?

An osteochondroma refers to the most common benign bone tumor in children. It typically presents as a bony projection (exostosis) on the surface of a bone. While generally noncancerous, it can cause pain or discomfort, depending on its size, location, and proximity to tendons or nerves. Osteochondromas usually develop during a child’s growth and may stop growing once skeletal maturity occurs.

What are the common symptoms of osteochondromas in children, and how is it diagnosed?

Common symptoms of osteochondromas can include:

Swelling or a palpable lump near a joint or on a long bone.
Pain, especially when the osteochondroma interferes with joint movement or presses against surrounding tissues.
Limited range of motion in the affected joint. Osteochondromas are often diagnosed based on clinical examination and imaging studies, such as X-rays. These studies can reveal the presence, size, and location of the tumor.

How do doctors treat osteochondromas in children, and what can parents do to support their child's well-being?

The treatment of osteochondromas depends on various factors, including the child’s age, the location of the tumor, and the severity of symptoms. Common treatment approaches include:

Observation: In many cases, osteochondromas do not require treatment and doctors monitor them over time, especially if they do not cause pain or functional impairment.
Surgical removal: When the osteochondroma causes pain, limits joint movement or can damage surrounding structures, doctors may recommend surgery. Pediatric Orthopedic surgeons conduct the surgery with excellent results
Pain management: Over the counter pain relievers or anti-inflammatory medications, as advised by a healthcare provider will control pain. Parents can support their child’s well-being by ensuring regular follow-up appointments with healthcare providers to monitor the osteochondroma’s growth and any related symptoms. Additionally, parents should educate their children about the condition and any necessary precautions to prevent injuries or discomfort. Osteochondromas typically do not interfere with a child’s overall health and development, and with appropriate management, most children can lead active and fulfilling lives.

The doctors and surgeons at the Medical City Children’s Orthopedics and Spine Specialists treat children with osteochondromas, which are the most common type of non-cancerous (benign) bone tumors

Is Osteochondroma Serious?

Osteochondroma is not generally considered to be serious. However, if the growth begins to put pressure on nearby tissue, nerves, blood vessels, or other bones, treatment may be necessary. There is a small chance (approximately 1%) that osteochondroma may become cancerous over time. This benign tumor has about a 1% chance of becoming cancerous over time. For this reason, doctors may want to keep it under surveillance. When multiple osteochondromas occur, the condition might affect a child’s ability to build bones normally. Occasionally, this condition might restrict movement. Our doctors will observe and monitor the patient for any issues in these circumstances. When a child has multiple osteochondromas, there is a 5% chance that one will develop into a malignancy.

What Causes Osteochondroma?

A solitary osteochondroma, which has no known source, is present in the majority of cases. It does not follow an injury. It is an anomaly in the development of bones. Multiple osteochondromas are often hereditary disorders brought on by a gene mutation. However, it can also happen at random (approximately one-third of the time) for unexplained causes.

What Does an Osteochondroma Look Like?

Osteochondromas range in size from 1 to 10 cm and extend outward from the line of a bone. They could resemble mushrooms or cauliflower because of their bulbous top and visible stem. Sessile osteochondromas are more frequent with inherited multiple exostoses, while pedunculated osteochondromas are more frequent in lone instances.

Should I be Worried?

It is quite uncommon for osteochondromas to need substantial medical care and surgery, and it’s even less frequent for benign bone tumors to develop into a malignancy. Our orthopedic expert for your child will guide you through the following procedures and collaborate with you and your child to track the tumor’s development.

What are the Symptoms of Osteochondroma?

Most of the time there are no symptoms. However, please note the following:

On one of your bones, a little, firm bump.
Symptoms of pain when performing a certain action if the tumor is pressing against a tendon.
When a tumor presses against a nerve, you may experience numbness or tingling in a specific area.
If the tumor is restricting a blood artery, it may cause circulation issues in a limb.

Multiple osteochondromas can interfere with a child’s natural bone development in more severe circumstances. Those kids who have this disease could have:

A short stature
A crooked limb
One arm or leg is bigger than the other
Displaced hip joint (hip dysplasia).

Key Points about Osteochondroma

An osteochondroma is an overgrowth of bone and cartilage at the growth plate at the end of the bone.
The shoulder blade, pelvis, and long bones of the leg are most frequently affected.
Osteochondroma’s precise etiology is unknown.
A hard, painless growth on an immobile bone, small stature for age, painful muscles, and an elongated arm or leg are possible symptoms.
Surgery to remove the growth or pain medications is a possible form of treatment.
To monitor bone development, parents should schedule follow-up exams with their doctor.

How are Pediatric Osteochondromas Identified?

In addition to a thorough physical examination and medical history, the following tests can identify osteochondroma in children:

X-ray: An X-ray takes photographs of a child’s bones and internal organs. This makes it easier to locate the growth. Most osteochondromas are easy to spot since they appear on an X-ray as a hard mass close to the growth plate on a normal bone. With the exception of cases when the tumor is discovered in an atypical site, such as the pelvis, the following diagnostic tests are often not necessary:

Magnetic resonance imaging (MRI): A diagnostic procedure that uses a combination of large magnets, radio frequencies, and computers to create detailed pictures of organs and structures inside the body. This test is especially useful for identifying tumors in areas that are difficult to show on plain X-rays. It also helps determine the size of the tumor and distinguish it from other types of bone tumors.

Computerized tomography scan: A diagnostic imaging procedure that combines X-rays and computer technology to create horizontal and vertical images of the body. A CT scan quickly provides excellent pictures of various parts of the body, including bones, muscles, fat, and organs. A CT scan provides far better detail than a typical X-ray.

Bone scans: A nuclear imaging procedure to look for malignancies, inflammation, and bone disorders. Doctors who treat children with several inherited exostoses may occasionally utilize this to look for additional osteochondromas.

Treatment

In most cases, if your child has an osteochondroma, they will need to have frequent follow-up checkups to observe the tumor’s development and make sure it isn’t causing them any discomfort or even weakening of their bones. Osteochondromas can occasionally cause issues that need surgical treatment. The tumor may occasionally grow in a region where it may be painful, swollen, numb, disfiguring, exhibit aberrant development, or exert strain on nearby blood arteries, nerves, or tissues. Our pediatric orthopedic surgeons will conduct surgery to remove the tumor in these situations without harming the growth plate. Your child’s pediatric orthopedic surgeon will arrange follow-up appointments to check on bone development if surgery is necessary. When a child is still developing and needs specific care, it’s crucial that they receive it from a pediatric orthopedic surgeon rather than an orthopedic surgeon who treats adults.

When is Surgery Needed?

If your child is in pain, has a fracture or nerve irritation, has a big or uncomfortable tumor, or if your child is experiencing any of these conditions in addition to discomfort, our doctors may advise surgery. Complete removal of the tumor is the preferred course of action when surgery is required. This entails removing the osteochondroma from the healthy bone by cutting it off and opening the skin around the tumor. Surgically removing the lesion is typically effective, depending on where the osteochondroma is located. It may be more challenging to do the surgery if the tumor is close to the blood vessels and nerves. There is a very slight probability (5%) that additional tumors will develop in the same place after they have been surgically removed.

Make an Appointment with the Best

At the Medical City Children’s Orthopedics and Spine Specialists, we treat children with osteochondromas. We specialize in this area and accept new patients. Give us a call to make an appointment if your child has these benign tumors. We have four offices for your convenience in Arlington, Dallas, Flower Mound, Frisco, and McKinney, TX.

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Footnote:

National Institute of Orthopaedic Surgeons: Osteochondroma

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