Exostosis
| Classification according to ICD-10 | |
|---|---|
| M89.9 | Exostosis |
| ICD-10 online (WHO version 2019) | |
Under exostosis (from Latin ex , out ', os , bone' and -ose disease) refers to a bone proliferation of compact bone ( Compacta ) those of the normal bone surface extends (in the vernacular: "ganglion"). The exostosis belongs to the hyperostoses and on the one hand can occur as a hyperplastic reaction and is then also referred to as an osteophyte . A hyperplastic reaction arises in response to a stimulus, such as pressure on a point, overuse of a tendon attachment, or inflammation of the periosteum . An exostosis can develop as a benign tumor as an osteoma , whereby there is usually a slow growth tendency . Exostosis can develop in any bone and is either symptom-free or characterized by pain , signs of inflammation, and restricted mobility. The metatarsal bones and the back of the hand are particularly often affected.
Types
Exostoses can occur on a wide variety of bones, for example, they are typical
- subungual exostoses (under the nails )
- Silverskjöld exostosis as an exostosis or osteophyte on the dorsum of the foot in osteoarthritis in the metatarsal area.
- (Pseudo-) exostoses of the metatarsophalangeal joint of the big toe (on the head of the first metatarsal bone - in connection with hallux valgus : the misalignment of the metatarsophalangeal joint of the big toe looks like an exostosis to the impartial observer, but it is actually just the wrongly positioned joint.)
- Carpal boss as exostosis back of the hand usually starting from the base of the second or third metacarpal , often with a ganglion confused
- Calcaneus spur , Haglund's heel (on the heel bone )
- Exostosebecken ( "thorn pool") (the area of the pelvis )
- Ear canal exostosis (in the ear canal )
- Cartilaginous exostoses / ecchondromas / osteochondromas (have a cartilaginous preformed part and often form at the ends of long bones, for example on the tibia or femur ).
- Mandibular exostoses (on the outside or inside of the lower jaw )
As a generalized disease, exostoses occur in hereditary dysplasia exostotica ( synonyms osteoplasia exostotica , multiple cartilaginous exostoses ). With this disease there is a clear tendency to recur, which only subsides as the person concerned gets older. A malignant dedifferentiation of this type of exostosis cannot be completely ruled out.
Symptoms
Depending on the localization, pain , signs of inflammation and possibly functional disorders occur. For example, auditory canal exostoses lead to a reduction in hearing . If cartilaginous exostoses grow into the course of a muscle, this can lead to significant functional impairments. It can happen that an exostosis that has grown into the muscle breaks off when the muscle is vigorously tensed. The consequences are similar to those of a broken bone with severe swelling of the affected extremity and high blood loss.
therapy
If such problems arise as a result of the exostoses, therapy consists of chiseling off the excess bone. It is important to consider whether the exostosis, which is harmless in itself, causes more difficulties than the expected scar. Under local anesthesia ( local anesthetic ) or general anesthesia is achieved, the tissue over the exostosis, then the bone with a drill or chisel is removed, the sealed section on the bone with a special wax and the wound is closed again. The external wound should heal in about 14 days, it may take longer to be free of symptoms.
