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Alex Brenner PT MPT OCS -> Re: Pain and swelling with running (September 22, 2005 11:07:00 PM)
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Here is some information on osteochondromas.
Osteochondroma is by far the most common of the benign tumors of the bone, comprising 9.3%% of all bone tumors in Dahlin's series. These are benign bone tumors characterized by cartilage capped bony growths that project from the surface of the affected bone. When the lesion is seen only in a single bone, it is called a solitary osteocartilaginous exostosis or osteochondroma. When the tumors are distributed over the skeleton and there is a familial history, they are then designated as multiple hereditary exostoses or osteochondroma. The individual lesions of solitary and multiple osteochondromas are basically identical radiographically and pathologically. The structure of the tumor consists of central core of bone marrow, which is identical to and continuous with the marrow of the underlying bone. This is enveloped by a cortex and periosteal covering, which are continuous with that of the affected bone. The tumor is capped by a layer of hyaline cartilage, which frequently extends well over the pedicle and sometimes approaches the normal cortex. The exostosis is produced by a progressive enchondral ossification of this growing cartilaginous cap. The cartilaginous portion of the osteochondroma acts as an enchondral plate for this abnormal growth and persists as long as there is growth activity. The growth usually stops when the nearest epiphysis has closed. The great majority of these tumors then becomes inactive during the adult life. Subsequently the cartilaginous cap tends to involve, but remnants usually persists.
A solitary osteochondroma usually arises in the areas where cartilage is ordinarily found. Although the lesions are not infrequently seen in the pelvis, most are seen in the metaphyseal regions of the long bones. About 1/3 are located in the distal femur and another 1/3 equally divided between proximal humerus and proximal tibia. About 7%% are seen in the ileum. In multiple hereditary osteochondroma, the lesions number from a few to a thousand with an average of 10 per patient. They are most frequently located in the metaphyseal portion of the long bones, particularly in the knee, ankle, shoulder and wrist.
The tumor usually comes to attention in childhood or adolescence, the greater majority in the second decade of life. The patient usually notices firm swelling not associated with any symptoms. If the tumor becomes large and bulky or located near nerves and blood vessels, it may cause discomfort by compression of the surrounding structures. Uncommonly, a fracture through the stalk can cause severe pain and hematomas. More uncommonly there have been reported cases of cauda equina syndrome from bulky osteochondroma of the lumbar spine and cases of traumatic aneurysm of popliteal arteries from sharply pointed osteochondroma.
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