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Osteochondroma Treatment Pune
We provide expert Osteochondroma care at Sancheti Hospital, ensuring safe tumor removal and prevention of recurrence through advanced orthopedic methods.
Overview
Osteochondroma is the most common benign bone tumor that affects people of all ages. Also known as osteocartilaginous exostosis, this condition creates a bony growth covered by a cartilage cap that extends from the surface of a bone. What makes this tumor unique is that both its outer layer (cortical bone) and inner core (medullary bone) connect directly with the normal bone underneath.
These growths typically develop near the growth plate – the area of cartilage at the ends of long bones where growth happens in children and teenagers. As young people grow, their osteochondroma may also grow larger, but this growth usually stops when they reach full skeletal maturity (around age 14 for girls and 16 for boys).
Most people develop just one osteochondroma, called a solitary osteochondroma. However, some individuals may develop multiple tumors, a condition known as Hereditary Multiple Exostoses (HME) or Hereditary Multiple Osteochondromas. While these are benign bone tumors, they can sometimes cause problems depending on their size and location.
Symptoms
Many people with osteochondroma experience no symptoms at all. These tumors are often discovered by accident during X-rays or other imaging tests done for different reasons. When symptoms do appear, they vary based on the tumor’s size, shape, and location.
Common symptoms include:
- Painless, palpable mass: The most frequent sign is a hard, unmovable lump on the affected bone. This lump may become painful if muscles or tissues rub against it during movement.
- Joint and muscle pain: Discomfort can develop when nearby tendons become irritated during physical activity.
- Exercise-related discomfort: Pain may worsen during physical activity, especially if the osteochondroma is located in an area that moves frequently.
- Bursa formation: A fluid-filled sac may develop over the tumor due to friction, leading to swelling and pain.
- Fracture pain: Sharp pain can occur if the narrow stalk of a mushroom-shaped osteochondroma breaks due to injury.
More serious symptoms can develop when the tumor affects nearby nerves or blood vessels:
- Nerve problems: The tumor may press on nerves, causing tingling, numbness, weakness, or even nerve damage. In rare cases, spinal osteochondromas can compress the spinal cord.
- Blood vessel issues: Compression of blood vessels can cause skin color changes, weak pulses, or reduced blood flow. Serious but rare complications include blood clots or aneurysms.
- Bone deformities: Multiple tumors can interfere with normal bone growth, leading to unequal limb lengths or angular deformities like knock-knees.
- Limited joint movement: If the tumor grows near a joint, it may physically block normal movement.
Causes
The exact cause of osteochondroma remains unclear, but researchers believe it stems from problems within the growth plate. One theory suggests that these tumors develop when pieces of growth plate cartilage become displaced and continue growing outside the main bone structure.
For solitary osteochondromas, changes in a gene called EXT1 are commonly found. These genetic changes usually happen randomly during a person’s development and are not inherited from parents.
Hereditary Multiple Exostoses (HME) is different – it’s an inherited condition passed down through families. This syndrome results from mutations in two important genes:
- EXT1 gene (located on chromosome 8)
- EXT2 gene (located on chromosome 11)
These genes are crucial for producing substances called heparan sulfate proteoglycans, which help regulate normal bone growth. When these genes don’t work properly, it leads to abnormal bone development and the formation of multiple osteochondromas.
Osteochondromas can also develop after:
- Bone fractures, particularly those involving the growth plate
- Radiation therapy, especially in children under two years old (with a delay of 3-17 years after treatment)
Risk Factors
Several factors can increase the likelihood of developing osteochondroma or experiencing complications:
- Family history: Having relatives with Hereditary Multiple Exostoses significantly increases risk, as this condition follows an autosomal dominant inheritance pattern.
- Age: About 75-80% of symptomatic osteochondromas are diagnosed before age 20, as growth typically mirrors skeletal development.
- Location: Tumors near joints (like the knee, thigh bone, or upper arm) or close to nerves and blood vessels are more likely to cause problems.
- Previous radiation: Children who received radiation therapy have an increased risk of developing secondary osteochondromas.
- Tumor type: Broad-based (sessile) tumors carry a higher risk of becoming cancerous compared to narrow-stalked (pedunculated) ones.
Diagnosis
Diagnosing osteochondroma typically begins with a physical examination where doctors can feel a firm, immovable mass near a bone. Several imaging tests help confirm the diagnosis:
X-ray: Usually the first test performed, showing the characteristic bony outgrowth with direct connection to the underlying bone.
CT scan: Provides detailed images, especially helpful for tumors in complex locations like the pelvis or spine.
MRI: Offers the most detailed view of the tumor and surrounding soft tissues. This test is particularly useful for measuring the cartilage cap thickness and detecting nerve compression or vascular compression.
Ultrasound: Used when blood vessel complications are suspected.
Biopsy: Rarely needed, but may be performed if doctors suspect the tumor has become cancerous, particularly if it’s growing rapidly or causing new pain in adults.
Types
Osteochondromas are classified into two main categories:
Solitary Osteochondroma: The most common form, accounting for 85% of all cases. Only one tumor is present, and it typically develops randomly rather than being inherited.
Multiple Osteochondromas (HME): This inherited condition involves two or more tumors. People with HME often develop numerous lesions throughout their body, which can lead to significant bone deformities and limb length differences. The risk of cancer transformation is also higher in HME.
Both types can appear in two shapes:
- Pedunculated: Has a narrow stalk extending from the bone
Sessile: Has a broad base attached to the bone
Treatment
Treatment depends on whether the osteochondroma causes symptoms, the patient’s age, and the risk of complications.
Observation: Most small, symptom-free osteochondromas require no treatment. Regular X-rays monitor for any changes, especially until skeletal maturity is reached.
Conservative care: For some cases involving muscle or joint pain, particularly in young athletes, chiropractic care may help. This can include:
- Therapeutic exercises
- Manual therapy
- Kinesio taping
- Ice therapy
Surgical excision: Surgery is recommended when the tumor causes:
- Persistent pain or discomfort
- Limited joint movement
- Nerve compression or vascular compression
- Fracture of the tumor
- Cosmetic concerns
- Suspected cancer transformation
During surgery, the entire tumor including the cartilage cap must be completely removed to prevent recurrence. For children, surgery is often delayed until skeletal maturity to avoid damaging the growth plate and affecting normal bone development.
Rehabilitation
Recovery after osteochondroma surgery varies based on the tumor’s size and location:
Small tumors: Recovery is typically quick, with swelling subsiding and incisions healing within two weeks. Most patients return to normal activities relatively soon.
Large tumors: Recovery may take 4-6 weeks and might require crutches. If additional procedures are needed to correct bone deformities, rehabilitation can extend to several months with structured physical therapy.
The main goals of rehabilitation are restoring function, reducing pain, and improving joint movement.
Complications
While benign, osteochondromas can cause several complications:
Cosmetic issues: Visible or palpable lumps can cause appearance concerns, especially in easily seen areas.
Mechanical problems:
- Bursitis: Inflammation of fluid-filled sacs that develop over the tumor
- Tendon irritation causing pain and “snapping” sensations
- Fracture of the tumor’s stalk
- Bone deformities and limb length differences
Nerve and blood vessel complications:
- Nerve compression causing tingling, numbness, or weakness
- Vascular compression leading to blood flow problems
- Rare but serious issues like blood clots or aneurysms
Cancer transformation: The most serious complication, where the tumor becomes malignant (usually chondrosarcoma). This risk is less than 1% for single tumors but 3-5% for HME. Warning signs include new pain, rapid growth, or a cartilage cap thicker than 2 cm in adults.
Prevention
Since osteochondromas are often genetic or develop randomly, direct prevention isn’t possible. For families with HME, genetic counseling may be helpful.
The focus should be on early detection and management through:
- Regular medical check-ups
- Monitoring for symptom changes
- Routine imaging studies
- Prompt evaluation of any new symptoms
Living With Osteochondroma
Many people with osteochondroma live normal, active lives without significant problems. Successful management involves:
Regular monitoring: Routine follow-ups with healthcare providers, typically orthopedic surgeons, including clinical examinations and periodic imaging.
Symptom management: Using conservative approaches like rest, ice therapy, or targeted exercises for pain control.
Activity modification: Making necessary adjustments to prevent irritation or injury while maintaining an active lifestyle.
Team approach: Working with various healthcare professionals including orthopedic surgeons, radiologists, physical therapists, and genetic counselors for comprehensive care.
Key Takeaways
- Osteochondroma is the most common benign bone tumor with a cartilage cap covering a bony growth
- Most cases are asymptomatic and discovered incidentally
- Causes include genetic mutations in EXT1 and EXT2 genes, particularly in HME
- Diagnosis relies on imaging studies like X-rays, CT scans, and MRIs
- Treatment ranges from observation to surgical excision based on symptoms
- The main concern is rare malignant transformation to chondrosarcoma
- Regular monitoring is essential for all patients
At Sancheti Hospital, we understand the complexities of osteochondroma and provide comprehensive care for patients with this condition. Our experienced orthopedic team specializes in diagnosing and treating both solitary osteochondromas and Hereditary Multiple Exostoses.
We offer advanced imaging facilities, expert surgical services when needed, and personalized rehabilitation programs to ensure optimal outcomes. Our multidisciplinary approach includes orthopedic surgeons, radiologists, and physical therapists who work together to provide the best possible care.
Whether you need routine monitoring, conservative treatment, or surgical excision, Sancheti Hospital is committed to helping you manage your condition effectively and maintain an active, healthy lifestyle.
Meet Our Ortho Onco Specialist
Patient Stories & Experiences
The pain in my left knee left me feeling helpless for years. After my treatment here, I can finally say I'm pain-free.
Vinita Singh
The nerves were swollen, and the body went numb. But thanks to Sancheti Hospital, I got a second life!
Parvati
I finally could walk again, a relief I've only felt after the hip pain surgery. I thank the doctors at Sancheti Hospital for their help.
Balaji Kharat
I'm a police officer, and I'm extremely thankful to Sancheti Hospital for treating my fracture without surgery.
Shantilal
My life has completely changed after the knee replacement surgery at Sancheti Hospital. It's like I can finally live again!
Kalpana Lepcha
The knee pain I've carried for years finally went away with the help of Sancheti Hospital.
Karuna
I can't believe that I get to finally live a normal and happy life, all thanks to the knee surgery I had at Sancheti Hospital.
Kishore Bhosle
Frequently Asked Questions
Can I play sports with an osteochondroma?
Most people can continue playing sports normally. However, contact sports may need to be avoided if the tumor is in an area prone to injury. Consult your doctor about specific activities based on your tumor’s location and size.
Will my child's height be affected by osteochondroma?
Single osteochondromas rarely affect height. However, multiple tumors (HME) can sometimes interfere with normal bone growth, potentially causing height differences or limb length discrepancies. Regular monitoring helps detect any growth issues early.
How often should I get check-ups for my osteochondroma?
Children typically need yearly check-ups until skeletal maturity. Adults with stable tumors may only need check-ups every 2-3 years. However, see your doctor immediately if you notice new pain, rapid growth, or changes in the lump.
Can osteochondroma come back after surgery?
Recurrence is rare (less than 2%) when the entire tumor including the cartilage cap is completely removed. Children have a slightly higher recurrence risk, which is why surgery is often delayed until they stop growing.
Is it safe to get pregnant with osteochondroma?
Yes, pregnancy is generally safe. However, hormonal changes during pregnancy might cause some tumors to grow slightly. Discuss with your doctor about monitoring during pregnancy, especially if you have HME or tumors near the pelvis.
