Exostosis: what is it? Causes of bone growths and modern methods of their treatment
Often, at the doctor’s office, patients hear a not entirely clear diagnosis — exostosis. What it is? How serious can such a disease be? What are its causes? These questions interest many people who are faced with a similar problem.
Exostosis – what is it?
Exostosis is nothing but a growth on the bone surface. By the way, such tumors can have different sizes and shapes. For example, there are growths in the form of a mushroom or cauliflower. Bone exostosis consists of compact spongy tissue.
In some cases, growths are formed from cartilage. Although, it is worth noting that the term “cartilaginous exostosis” is a bit incorrect.
Yes, the neoplasm arises from the cartilaginous elements, but then it stiffens, turning into spongy tissue.
And its surface is covered with hyaline cartilage, which, in fact, is a growth zone.
Exostosis and the reasons for its formation
In fact, the reasons for the formation of such growth can be different. As a rule, neoplasms are the result of excessive tissue growth at the site of bone injury — this is often observed in fractures, fissures, surgery, etc.
But there are other risk factors. According to statistics, children and adolescents most often encounter such problems, which are often associated with physiological features, namely growth intensity.
In addition, hereditary relationships are often tracked. In addition, various chronic inflammatory diseases of the bones can be attributed to the causes. Sometimes growths appear on the background of fibrositis and inflammation of the mucous bags.
The cause may be chondromatosis of the bones, as well as aseptic necrosis. Quite often, exostoses develop in people with congenital anomalies of the skeleton. In addition, growths may indicate a benign bone tumor, being a complication.
It is worth noting that doctors are not always able to find out the causes and origin of the disease.
In most cases, growths do not cause any discomfort to the person.
The disease is asymptomatic and is found completely by chance during a routine examination.
However, some people have signs that help diagnose exostosis. What are these symptoms?
First of all, it is worth noting the discomfort and pain that occurs during movements, pressure on the bone or physical tension (depending on the location of exostosis).
The intensity of these symptoms, as a rule, increases with the growth of the tumor. If the growth is located closer to the joint, it can significantly limit the amplitude of movements.
Quite often, exostosis can be felt, sometimes even independently.
Modern diagnostic methods
In fact, this disease is relatively easy to diagnose.
The doctor may even suspect the presence of growths during the examination of the patient, since the growths in some places are easily felt under the skin.
In addition, history and present symptoms play an important role in the diagnosis.
To confirm the diagnosis, the patient is prescribed an x-ray examination. Exostosis is easy to see in the picture. By the way, the actual size of the growth, as a rule, is a few millimeters larger, since the cartilage tissue is not visible in the X-ray.
In some cases, additional research is required.
This is especially true for those cases where the growth is rapidly increasing in size, because there is always the possibility of a malignant degeneration of cells.
In such cases, patients are prescribed a biopsy, during which they take samples of tissue with further cytological laboratory tests.
In fact, in modern medicine there is only one method of treatment – removal of exostosis by surgery. Naturally, surgery is needed not every patient.
After all, as already mentioned, quite often such growths do not pose any threat to health, and the disease does go without any visible symptoms.
Surgical removal of exostosis is necessary if the tumor is larger or grows too fast. In addition, the indication for surgery is severe pain and problems with movement.
Some patients agree to have surgery if the growth is a strong cosmetic defect.
Modern methods of medicine can get rid of tumors in the shortest possible time. Bone exostosis is removed through a small incision 1-2 centimeters long.
Such an operation is considered minimally invasive, does not require special training, prolonged hospitalization and rehabilitation – as a rule, after only a few days after the procedure, people begin to gradually return to normal life.
Bone exostosis and possible complications
As already mentioned, in some cases even a small bone growth can lead to a lot of problems and affect the quality of life. Moreover, there are some complications with which exostosis is fraught.
What are these problems? For a start, it is worth noting that a greatly enlarged neoplasm often rests on adjacent bones, which leads to their gradual deformation.
Fractures of the leg of exostosis can also be attributed to complications, which, however, is extremely rare. But the greatest danger remains the risk of malignant degeneration.
In some patients, the appearance of such a growth was a precursor of the appearance of a tumor – most often cancer affects the bones of the pelvis and thighs, as well as vertebrae and scapulae.
Symptoms of exostosis and features of its treatment
About exostosis, few people know, despite the fact that this disease is not rare. The disease can develop in both a child and an adult. However, most often the person does not even suspect about the disease, since it does not cause any discomfort and is asymptomatic.
Causes of disease
Exostosis is a bone or bone and cartilage growth on the surface of the bone.
This is a benign tumor several millimeters thick, consisting of cartilage tissue. But as it grows, the tumor hardens and turns into bone growth.
The disease can develop even in a young child, but up to 7–8 years, as a rule, does not manifest itself.
In most cases, it is diagnosed in adolescence during the examination.
The danger of osteo-cartilaginous exostosis is that it may not manifest itself for a very long time, growing to an enormous size.
Although it is quite simple to diagnose it: the growth is felt under the skin. Also, tumors are visible on the X-ray.
The causes of the disease are as follows:
- injuries and damages in childhood and adolescence, when intensive tissue growth occurs;
- chronic diseases of the skeletal system;
- complications after inflammation in the body;
- congenital anomalies of the skeleton;
- excess calcium in the body, settling on the bones;
When exostosis can be observed several growths. Sometimes their number reaches several dozen. They can be of different sizes and shapes. There are growths in the form of a ball, an inverted bowl, and even in the shape of a flower.
Classification and Diagnosis
Usually neoplasms are noticed during X-ray examination.
However, only the ossified part of the growth is visible in the picture, and the cartilaginous “cap” covering the growth is invisible.
Therefore, the actual size of the tumors is always larger than that seen on the x-ray. But the X-ray examination shows the number, shape and stage of tumor development perfectly.
Exostosis manifests itself in different ways. Most often, the disease can develop over the years until it is discovered by a doctor. But there are cases when the tumor presses on the nerves and blood vessels. Then the person feels pain when pressing on certain areas of the body or feels numb.
If the growth is located near the joint, then it limits the movement of the limbs. Sometimes exostosis is accompanied by vertigo. In such cases, the patient undergoes additional examinations.
If the disease develops with complications, and the growth itself grows rapidly, that is, the risk of transforming the neoplasm into a malignant tumor.
Then they perform a biopsy with tissue sampling to better study the development of the disease.
The disease is divided into 2 types:
- Solitary exostosis, manifested as a single growth.
- Multiple chondrodysplasia, characterized by several tumors. Multiple growths appear in several areas at once. This type of disease is hereditary.
Most often, exostosis is diagnosed on such parts of the body:
- hip joint;
- shoulder joint;
In half of the cases, exostosis of the femur and tibia is diagnosed.
One of the most severe types of the disease is exostosis of the spine.
A tumor on the spine can affect the spinal cord, leading to abnormalities in its function. The marginal exostoses of the vertebral bodies interfere with their normal mobility.
In addition, vertebral growths often turn into malignant tumors.
No less dangerous exostosis of the knee joint. A growing tumor causes inflammation and deforms the joint, impairing its function.
Hands and feet are less likely to be affected. Usually reveal hereditary exostosis of the calcaneus and metatarsal.
Exostosis is treated in only one way – surgery. However, some patients may not need surgery. Usually, surgery is prescribed for children who have reached the age of majority.
Until this time, the growth may be reduced and completely dissolve. For example, exostosis of the rib behaves, which is detected in children 8–18 years old.
In most cases, it is a complication of various diseases and eventually passes spontaneously.
If the bone growth does not increase and does not cause any discomfort, then some people live with him all his life, occasionally being seen by a doctor.
Indications for removal of exostoses are:
- significant size of the tumor or its rapid growth;
- the risk of transforming growths into malignant neoplasms;
- pain due to pressure growths on the vessels and nerve endings;
- various cosmetic defects.
As a rule, the operation to remove tumors does not require special preparation. The neoplasms are removed along with the periosteum adjacent to the tumor to avoid relapse.
Operations are performed under general anesthesia, as well as under local anesthesia, if the case is simple.
Even after an operation on the part of the thigh or foot, the patient returns to a full life within a few weeks.
When the affected part of the body should be protected, it is immobilized for some time after the operation with a plaster splint. Then the patient undergoes a course of rehabilitation procedures. If all medical recommendations are followed, the patient recovers quickly.
Only in rare cases are complications possible when the disease recurs. An eruption appears again and is a harbinger of malignant neoplasms. Most often, a malignant tumor affects the vertebrae, the bones of the thigh and pelvis, and the scapulae.
Despite the fact that exostosis is a disease that requires surgical intervention, many are trying to cure bone growth at home.
Some turn to traditional healers, others take information from the Internet, reviewing questionable treatment photos and using unverified recipes.
Unfortunately, self-treatment often only complicates the situation.
As a rule, patients begin treatment with folk remedies when the bone growth causes severe discomfort. To relieve pain, many make herbal compresses and lotions. Such methods are not harmful to health, but exostosis is not treated.
Having failed to achieve a result with the help of herbal recipes, patients switch to radical preparations – painkillers and various ointments. However, such methods are already fraught with complications.
- First, thoughtless use of painkillers has a negative effect on such internal organs as the liver, kidneys and stomach.
- Secondly, a benign tumor can turn into a malignant tumor, and drugs used without prescription can only accelerate this dangerous process.
Yet popular methods are not so harmful in the treatment of exostosis, if they are prophylactic in nature. First of all it concerns a way of life.
Normal nutrition, immunity, sports – all of this protects against the development of exostosis, even when getting injured.
Some diseases of the internal organs can also trigger the appearance of a tumor on the bones. To avoid this, it is necessary to carefully monitor their health and in time to treat various ailments.
Doctors often prescribe various compresses and baths to patients in order to reduce pain or relieve swelling. The use of home methods is possible after the operation, however, no prescription should be used without consulting with your doctor.
Exostosis: symptoms and treatment, removal of exostosis, complications, prevention
Exostosis – bone or bone and cartilage growth of the bone of non-tumor etiology.
Initially, a growth arises on the bone, consisting of cartilage tissue, which later becomes harder, gradually reborn into a spongy bone.
The surface of the newly formed bone remains covered with cartilage, which hardens.
This cycle can be repeated to infinity, ensuring the growth of the tumor. The process proceeds painlessly, developing extremely slowly.
The maximum size of the tumor reaches ten centimeters or more.
New growth occurs, as a rule, in the period of bone growth and skeleton formation in adolescence.
Causes of exostosis. Forms and localization of exostosis. Diagnosis and treatment of exostosis. Complications Prevention
Causes of exostosis
According to some experts, hereditary deviations can serve as the causes of the occurrence of this disease, but this theory has not received scientific confirmation.
The main factors for the occurrence of exostoses are considered to be:
- various inflammatory processes;
- bruises and bone injuries;
- developmental disorders of the periosteum and cartilage;
- endocrine disorders;
- infectious diseases of various etiologies.
The most significant factor provoking the appearance of exostosis is an excess of calcium in the human body, which is just deposited on the bones and forms growths. Causes of excess calcium can be excessive consumption of dairy products, eggs, parsley, cabbage, hard water.
The second name of ekosostoza – osteochondroma.
So in medicine is called a benign bone tumor consisting of bone and cartilage tissue.
In early childhood, the disease is rarely diagnosed, its development is observed mainly in puberty in adolescents.
Forms and localization of exostosis
With solitary form osteo-cartilaginous exostosis, there is a single tumor. It is immobile, and may be of different sizes. Growing up to a considerable size, the tumor can put pressure on the nerves, blood vessels and lymphatic vessels.
The second form is multiple exostose chondrodysplasia. In this case, there are several tumors. It is believed that this type of disease is most prone to inheritance.
Favorite places of localization of exostosis are the femoral and tibial bones – about half of the cases fall to their share.
Also in the “risk group” are the hip bone, scapula, collarbone, shoulder joint.
The bones of the feet and hands are extremely rare, and cases of the appearance of tumors on the skull bones are not officially recorded.
The most dangerous localization of exostosis is the vertebral column..
When a tumor grows, a spinal cord squeeze is possible, which can lead to the most serious disorders of the central nervous system.
There is also a risk of rebirth of a benign education into a malignant one.
Diagnosis and treatment of exostosis
The disease develops extremely slowly, this process goes absolutely without any symptoms. Signs in the form of pain, dizziness, headache, numbness of areas of the body, goose bumps are possible when the tumor squeezes the blood vessels and nerves.
The disease is detected either visually (when the growth reaches a fairly large size), or accidentally during the x-ray diagnosis of other diseases. The final diagnosis for exostosis is established only with the help of X-rays.
Note: when determining the size and shape of the tumor, one should not forget that only the bone part of the growth is visible in the picture, and the cartilage tissue is not detected. Therefore, the true size of the tumor will be different from that shown on the x-ray in a big way.
Treatment of exostosis is possible only by surgical methods. Drug treatment methods of this disease simply does not exist.
Conducting surgical removal of growths is not recommended for persons who have not reached the age of majority, since during the formation of bone tissue growths can disappear by themselves.
Surgical intervention is indicated in the case of rapid development of a neoplasm, especially if due to the large size, nerves or vessels are trapped.
The operation can be performed both under general anesthesia and under local anesthesia. The choice of anesthesia method depends on the size and location of the tumor.
The intervention technique itself is fairly simple, the bone formation is removed with a chisel, and the bone lesion is smoothed.
The recovery period lasts about a couple of weeks.
If the surgery was insignificant, for example, one small tumor was removed, then the next day the patient is able to move independently.
At the first stage of recovery, it is important to observe the most gentle mode of movement. After the edema completely subsides or decreases to a minimum, rehabilitation therapy begins.
Recovery is reduced to exercises aimed at returning lost muscle mass and strength. When the training stops causing physical pain and causing discomfort, then rehabilitation can be considered successfully completed.
In principle, exostosis does not apply to diseases that cause dangerous complications. But in the case of localization of the tumor on the spine, a compression effect on the spinal cord is possible, which is fraught with the most serious consequences.
A rarely diagnosed fracture of the leg of exostosis. Multiple chondrodysplasia in childhood and adolescence, in some cases, can lead to impaired proper development and deformation of the skeleton.
Sometimes, especially with rapid growth, tumors can degenerate from benign to malignant, which most often manifest as chondrosarcoma or spindle cell sarcoma, the favorite places of which are the bones of the pelvis, spine, femurs, scapulae.
Prevention, as such, is reduced to identifying exostoses at the earliest stages. Regular medical examinations contribute to the achievement of these goals. Given the risk of skeletal deformity, early diagnosis is particularly relevant for children and adolescents.
Examination is also necessary after injuries of the musculoskeletal system, because even a minor injury or fracture can serve as an impetus to the occurrence of pathology.
And as mentioned above, it is highly desirable to regularly monitor the level of calcium in the body, because people with elevated calcium content are at risk.
By and large, despite the etiology, exostosis does not belong to the group of dangerous diseases. Rebirth of a tumor into a malignant occurs extremely rarely.
This tumor does not pose a serious danger to human life and health. In children, there are cases of spontaneous cure, without the intervention of physicians.
What are exostoses and how should they be treated?
The crunch and aging of the musculoskeletal system
Exostoses – what kind of disease it is and what are the consequences, it is necessary for all parents to know. Mainly affects the disease of children and adolescents from 8 to 17 years.
Exostosis is a bone and cartilage growth on the surface of the bone, which can be formed both in a single and in multiple formations.
Growing up, the bone tumor can squeeze nerves and blood vessels, with multiple exostoses, the human skeleton is deformed.
- 1. Causes of the disease
- 2. Symptoms and diagnosis
- 3. Pathology Therapy
Osteo-cartilaginous exostosis occurs without any symptoms and remains unnoticed for a long time. It is possible to detect the disease in the early stages by chance with an X-ray of the affected area, or when the growth is greatly increased and begins to cause inconvenience to the patient.
Exostoses can be spherical and flat. Sizes range from a small pea to a large apple. The rapid development of pathology begins in adolescent puberty.
The disease affects the tibia, the clavicle, the scapula and the lower part of the thigh. Rarely growths occur on the hands and feet.
Special discomfort delivers exostosis of the calcaneus and the knee joint.
When reaching a significant size, they impede movement, in some cases causing pain.
Causes of disease formation:
- injuries and bruises of the bone;
- inflammatory processes of mucous bags;
- abnormalities of the periosteum and cartilage;
- after surgery;
- chondromatosis of the bones;
- endocrine system disease.
Most often, the disease is hereditary and speaks of a violation of normal enchondral ossification. If parents have such a pathology, regular examination of the child is necessary.
Osteo-cartilaginous exostosis is divided into solitary, which is represented by only one tumor, and multiple exostose chondrodysplasia – the appearance of several formations.
In most cases, bone growth does not bring any discomfort to the child. The initial stage proceeds without symptoms. Symptoms of the disease can occur with a significant increase in the tumor.
The main symptoms of exostosis:
- when feeling, you can feel a tight knot in the modified area;
- painful pressure;
- at the location of the growth near the joint restriction of its mobility;
- if the growth on the bone pinches the nerve endings, then there is a feeling of tingling, numbness of nearby tissues;
- as education increases, the pain begins to intensify.
Patients usually find enlarged growths randomly on palpation of various parts of the body, such as exostosis of the calcaneus. Basically, the protrusion is localized on the heel and injured by shoes.
The result is a sharp pain, swelling of the legs and restriction of movement. The exception is the exostosis of the knee joint, which develops from the femur under the quadriceps muscle and is not available for palpation.
Growing up, the tumor crushes, stretches and deforms the muscle, sometimes a mucous bag develops under it.
Knee exostosis can cause severe discomfort, interfering with movement. Large growths put pressure on the adjacent bones, with the result that the leg of exostosis can break and cause joint inflammation and impairment of its functions.
During the initial examination, the diagnosis is carried out by palpation of the patient’s body parts. But the whole picture and the degree of growths can be seen only on the X-ray, which will show how many bones are captured and the number of exostosis formations.
Osteo-cartilaginous exostosis is treated only by surgery. If growths do not cause discomfort and do not squeeze the organs, they are periodically monitored. Children under the age of 18 try not to perform operations, as in many cases there is an independent resolution of growths.
Indications for surgery:
- rapid growth of exostosis;
- movement restriction;
- the growth on the bone is large;
- pain sensations;
- health hazard;
- create a cosmetic defect.
The disease cannot be treated with physiotherapeutic procedures, as this may trigger a transition to a malignant tumor.
The operation is performed under local or general anesthesia, depending on the location and size of the growth. The essence of surgery is to remove exostosis and smooth the bone.
The nature of the operation is determined by the size and number of growths. First of all, the largest and exostoses, which compress the nerves, are removed. Heel bone surgery is performed under local anesthesia.
A small incision is made in the area of the tendon or endoscopy is used. With an open procedure, the tendon is pushed aside and a protruding area is cut with a special device.
If there is a mucous bag, it is subject to excision. The wound is sutured and a sterile bandage is applied.
During exostosis of the knee joint on the back surface, the tumor is removed, grabbing a healthy part of the bone. After that, put a plaster splint on the leg for 12-15 days.
After removal of the edema and pain syndrome, physiotherapy exercises are prescribed to restore joint mobility. In all cases, after surgery requires gentle motor mode.
Treatment by conservative methods is aimed only at reducing periodic inflammation. Assign nonsteroidal anti-inflammatory drugs and ointments.
With severe discomfort, a blockade is performed in the area of exostosis, which for a long time will allow to relieve pain.
If within 2 weeks the situation does not improve, prescribe surgery.
To date, there are no specific measures for the prevention of exostosis. The disease can only be observed and controlled by the growth on the bone. It is necessary to conduct periodic examinations of children, especially after injuries that can trigger the mechanism of the disease.
Osteoma – exostosis: symptoms and treatment
Osteoma is a benign neoplasm that develops from bone tissue.
Osteoma is characteristic of patients of child and young age (in the period from 5 years to 21 years).
Osteomas are mainly localized on the outer surface of the bones and on the flat cranial bones, and may also appear on the walls of the ethmoid, frontal, sphenoid and maxillary sinuses and on the hip, shoulder and tibial tubular bones. Possible damage to the bones of the spine. Osteomas are usually solitary, but they are also multiple (Gardner’s disease).
Osteoma of the frontal sinus on x-rays
If the osteoma reaches a considerable size and squeezes the adjacent areas (for example, blood vessels, nerves, etc.), this can cause the manifestation of the corresponding symptoms and, in the case of dysfunction of the squeezed areas or organs, requires surgical removal. In other cases, the osteoma is removed for cosmetic reasons.
Depending on the origin, specialists distinguish two types of osteomas:
- hyperplastic osteomas are tumors that develop from bone tissue. This group includes the osteomas themselves and the so-called osteoid osteomas (synonym: osteoid osteomas);
- heteroplastic osteomas – neoplasms arising from connective tissue. Differently such osteomas are called osteophytes.
This is a bone tumor with high differentiation, but, unlike osteoma itself, its structure differs from that of normal bone tissue.
It consists of vascular-rich areas of so-called osteogenic tissue, randomly scattered bone beams, and zones of bone tissue destruction (osteolysis). Usually osteoid osteomas are rarely more than 1 centimeter in diameter.
This is a fairly common disease. Its share in the total number of benign bone tumors is about 12 percent.
It can be localized on any bones of the body, except for the bones of the skull and sternum. More common in men.
The course of this disease is characterized by gradually increasing pain. At the early stage of the development of the disease, these sensations are similar to muscle pain.
Over time, the pain intensifies and occurs spontaneously. Sometimes there is lameness.
In the event of a tumor in the articular part of the bone (epiphysis), fluid may accumulate in the joint.
If the tumor is located in the area of the growth zone, then it stimulates bone growth, as a result of which skeletal asymmetry may develop in pediatric patients.
If the osteoid osteoma is localized in the spine, scoliosis is possible. With a similar location of osteoid osteoma, there is a risk of compression of the peripheral nerves.
Exostosis of the nail phalanx
Osteophytes (endo- and exostoses)
There are two types of osteophytes:
- internal osteophytes (in a different way – endostoses) grow into the bone marrow canal. As a rule, they are rare, but there is an exception – a hereditary disease known as osteopoikylosis. In this case, multiple endostoses are observed. The course of the disease in the majority of cases is not accompanied by severe symptoms. Often diagnosed by chance during X-ray examination;
- external osteophytes (in other words – exostoses). As their name implies, are formed on the surface of the bone. The cause of the appearance of exostoses can be various pathological processes, but their occurrence is possible without any apparent reason. Exostoses are most commonly found on the bones of the face, skull and pelvis. Manifestations of the development of these osteophytes may not be at all, or they manifest themselves as a cosmetic defect, or, in the case of squeezing of nearby areas, are manifested by the corresponding external signs. There are cases when the development of exostosis was accompanied by deformation of the bones and fracture of the leg of the external osteophyte.
Since exostoses are more common for endostoses, consider them in detail.
What is exostosis?
Often, having heard the diagnosis of “exostosis” at the doctor’s office, patients are frightened. How serious is this disease? Where does it come from?
Such tumors have various shapes and sizes. For example, there are exostoses in the form of a mushroom or cauliflower. The structure of this formation is a compact spongy compact fabric.
There are cases when growths are formed from cartilage. It should be noted that the use of the term “cartilaginous exostosis” is a bit wrong.
The neoplasm, although it appears from the cartilage elements, but subsequently becomes stiff and turns into spongy tissue.
And its surface is covered with hyaline cartilage, which is the growth zone of exostosis.
When forming on the long tubular bones of the limbs, the growths are most often localized on the thigh bones. In the second place in frequency is the tibial bone, in the third – the humeral bone.
This is often observed with cracks, fractures, surgery, and so on.
Also, the causes of this disease include various kinds of chronic inflammatory bone diseases.
In some cases, exostoses can be formed against the background of inflammation of mucous bags and fibrositis. Aseptic necrosis and bone chondromatosis can provoke the appearance of growths.
Exostoses often appear in patients with congenital anomalies of the skeleton.
However, in some cases, there are signs that help diagnose “exostosis”. What are these signs?
As the disease progresses and exostosis grows, these symptoms become more pronounced. If the growth is localized in the immediate vicinity of the joint, this can severely limit the amplitude of the movements. Often this tumor can be felt, in some cases even independently.
Sore bones with exostosis
Currently, this disease is relatively easily diagnosed.
Suspicion of exostosis by a doctor may occur at the stage of examination of the patient (in some parts of the body, the growth is easily felt under the skin).
Of course, the emerging symptoms and history are important in the diagnosis. To ensure the correctness of the diagnosis, an x-ray examination is prescribed.
It should be said that the actual size of the growth is often several millimeters larger than in the picture, because the cartilage tissue is not visible on the radiograph. Sometimes additional examinations are needed.
This is especially true in cases in which a neoplasm is rapidly increasing in size. In these cases, a tissue biopsy is prescribed, followed by cytological examination in the laboratory.
Of course, such an intervention is far from always necessary, since in most cases exostoses are not harmful to health, and the disease itself is generally asymptomatic.
The existing methods allow to get rid of exostosis in a short time. Bone growth is removed through a cut length of one to two centimeters.
Such intervention does not require special training, a long stay in the hospital and a long rehabilitation.
In most cases, the patient after removal of exostosis begins to return to normal after a few days.
Osteo-cartilaginous exostosis of the fibula
In some cases, even small exostosis can cause a lot of problems and seriously affect the quality of life.
One of the possible complications is a fracture of the leg of exostosis (although such cases are extremely rare). However, the greatest threat remains the risk of “malignancy.”
There are cases when the appearance of such growth was a precursor to the formation of a tumor – most often cancer of the pelvis and femur bones, as well as of the shoulder blades and vertebrae.
Osteo-cartilaginous exostoses are considered congenital pathologies. But they begin to grow actively under the influence of provoking factors. This happens especially in adolescence.
Most exostoses do not cause the patient painful or other discomfort. But the exostosis of the calcaneus is slightly different. This pathology can occur at any age.
Features of the location of the growth lead to the fact that there are severe pains that often make it impossible for a person to move normally.
Such growth, or, in a scientific way, osteochondroma, consists of cartilage cells and grows on the surface of the bone. It may have a different shape and grows to a size of 1.5-2 cm.
If he does not squeeze the surrounding tissue and does not cause pain, do not touch him. But in the area of the calcaneus, exostosis usually interferes with walking.
And the only treatment for this pathology is surgical removal of the growth.
The growth of bone tissue in the heel area can be localized on its plantar part or behind it. Moreover, the formation of even a small size interferes with walking and causes severe pain, as it irritates the surrounding tissues.
If it is mushroom-shaped, it can squeeze the nerve plexus, which leads to numbness of the foot and loss of skin sensitivity, the semicircular growth always causes severe pain, and the linear growth in the form of a spike damages soft tissues and leads to the development of inflammation.
At the initial stage, pathology is very difficult to detect. While she does not cause pain or changes in the soft tissues, patients do not even go to the doctor. The growth itself first consists of cartilage tissue, and therefore is not visible on the X-ray.
Gradually, dense bone tissue is formed inside the soft shell of hyaline cartilage. Exostosis grows due to the proliferation of cartilage tissue. This distinguishes it from osteophytes, which are an acute bone growth that is most often formed in the area of the joints.
On the heel, they also form, but always after a long inflammation or injury.
Osteo-cartilaginous growth may form on the plantar surface of the calcaneus.
Often, the bone-cartilaginous exostosis on the plantar part of the heel is called the “heel spur.” This name stuck among patients, although the “spur” is rather an acute osteophyte growth.
And exostosis is an osteoma of bone and cartilage tissue. In addition to the plantar surface, such a growth may form on the upper part of the heel bump.
This pathology is also called posterior exostosis, or Haglund deformity.
According to their structure, such formations can be of several varieties:
- solid osteoma is a layering of bone tissue on the surface of the bone;
- spongy osteoma consists mainly of soft cartilage tissue, it can be spherical or mushroom-shaped;
- cerebral osteoma contains bone marrow and is not formed on the heel.
In most cases, osteo-cartilaginous exostosis develops in those patients who have a genetic predisposition or any congenital pathology of bone and cartilage tissue. But in the first years of life, growths are not formed.
They begin to grow under the influence of provoking factors. It may be injuries or increased stress on the foot. Therefore, often growths are formed in athletes, dancers or people working on their feet.
It is noticed that women are more susceptible to the appearance of exostosis of the calcaneus.
Most often, exostosis is formed for such reasons:
- after calcaneal trauma, which leads to severe inflammation or abnormal cell growth;
- Constant wearing of narrow uncomfortable shoes, frequent walking in high heels or on a completely flat sole;
- large weight and other increased load on the foot;
- flat feet or valgus deformity;
- impaired blood circulation, leading to deterioration of tissue nutrition;
- effects on the cartilage tissue of infections – syphilis, gonorrhea, influenza, osteomyelitis, periostitis;
- endocrine diseases and metabolic disorders.
The heel on the calcaneus irritates the surrounding tissues when walking, therefore it causes severe pain
The bone and cartilage formation on the heel grows gradually. Usually, until it reaches a size of 1 cm, it does not cause any discomfort.
With larger growths, it can already be felt and even noticed. Such a seal may form on the posterior surface of the heel bone or on its plantar part.
But in any case, the growth is strongly hampered when walking.
Another article: How to treat heel pain
Most often, patients go to the doctor because of pain. They are strongest in the morning or after prolonged immobility. Then they subside a little.
And with increased physical activity again increased in the evening. If the size of the growth on the plantar surface is more than a centimeter, it causes a sharp pain when walking.
Therefore, patients are often forced to use a cane.
In addition to pain, edema develops due to constant irritation with the growth of soft tissue, inflammation of the ligaments and tendons often occurs.
For example, plantar fasciitis is a natural consequence of exostosis on the plantar part of the heel. Often, the Achilles tendon is also inflamed. The skin grows coarse overgrowth, appear calluses.
Hyperemia is often noticeable, palpation is a painful place.
The skin above the place of growth grows coarse, often develops inflammation of soft tissues.
Constant pain can lead to deformation of the fingers, disruption of the functioning of the joints, the development of flatfoot. The consequences of the pathology is also numbness of the skin of the foot, a tendency to fractures and dislocations of the joint.
Some patients, especially the elderly, do not go to the doctor with this pathology, preferring to remove the pain on their own. Such an approach threatens with many complications, the most serious of which is the degeneration of the cells of formation and its transformation into a cancerous tumor.
After all, exostosis very rarely disappears on its own, only in adolescence may a reduction in growth. But usually the pathology gradually progresses, the formation grows, increasingly irritating the surrounding tissues.
Therefore, it is very important to consult a doctor in time when heel pain appears.
After all, the treatment of exostosis is possible only surgically, no drugs or traditional methods will reduce the growth.
They have only a symptomatic effect, facilitating the patient’s condition. At the same time, the growth of education is continuously monitored to prevent complications.
In addition, it is very important to eliminate the causes that led to an increased proliferation of bone and cartilage tissue. Without this, even after surgical removal of the growth after some time, it can form again.
In many cases, only surgical treatment of exostosis on the calcaneus is possible.
Get rid of the bone and cartilage growth can only be surgically. But the operation is not carried out for all patients with this pathology.
The indications for surgical treatment are severe pain, the development of inflammation, the rapid growth of education.
The operation is also necessary in the event that the growth prevents you from walking or does not allow you to wear ordinary shoes.
The operation is performed under local anesthesia. Often the patient has a lot of growths. In this case, only the largest and those that compress the surrounding tissue are removed.
After anesthesia, a small incision is made and the growth is removed. After that, smooth the surface of the bone and impose a cosmetic seam.
The operation is considered simple, so the patient’s full return to normal life occurs within 1-2 weeks.
If the growth is still not very large and does not cause much discomfort, symptomatic treatment is possible. His task is to eliminate pain, swelling and inflammation. First of all, it is necessary to avoid traumatizing soft tissues.
To do this, choose a comfortable, orthopedic best shoes. Under the heel you can put a special insole or felt pads. This will help reduce the pain when walking.
In addition, it is recommended not to stand on your feet for a long time.
To relieve pain, you can use nonsteroidal anti-inflammatory drugs in the form of tablets or ointments.
Especially well relieve pain “Diclofenac”, “Ibuprofen”, “Ketoprofen”, “Voltaren gel” or a solution of “Dimexide”.
Sometimes it is required to carry out a blockade by introducing hormonal agents into the heel area: “Hydrocortisone”, “Diprostpan” or “Kenaloga”.
Effective for relieving inflammation of soft tissues and ligaments of physiotherapy. The most commonly used are:
- warm footbaths, best with healing mineral water;
- foot massage;
- electrophoresis with potassium iodide or with Novocain;
- shock wave therapy;
- magnetic therapy;
- laser heating;
Shock-wave therapy is successfully used to relieve pain and inflammation.
At the initial stage, if the pain is not strong, and the growth does not squeeze the nerves and does not violate the blood circulation, the use of folk methods is possible. They will help relieve pain and reduce inflammation. Most often, different compresses, ointments, foot baths are used for this.
Compresses should be warming, so the leg is wrapped with polyethylene. In addition, for better penetration of medicinal substances, it must first be steamed. After the use of foot baths, it is useful to make an iodine net on the sore spot and wear warm socks.
It is better if the procedure is performed at night.
- Fat compress can help relieve pain and soften rough skin. You can use bear, badger or pork fat. This compress is imposed on the night.
- Grate raw potatoes and put on a sore point. Wrap and hold for 4-5 hours.
- Such a composition is effective for compresses: 100 ml of aloe juice, the same amount of alcohol, a bottle of valerian, half a teaspoon of red pepper and 2 tablets of Aspirin and Analgin each. The composition is well mixed and infused in a dark place for 2 weeks.
- Well for the night to make a compress from medical bile.
- Effectively relieve fatigue, swelling and pain of foot baths with salt. Make a strong brine of 5 liters of water and 1 kg of salt. You can add a few drops of iodine or soda.
- Baths with clay help to remove salts and reduce inflammation.
- Useful massage coarse salt. To do this, a kilogram of salt must be heated and spilled on a flat surface. On warm salt you need to walk barefoot.
You can also use the means for oral administration. They are needed for the normalization of metabolic processes, nutrition of bone tissue, improve blood circulation and strengthen the immune system. The best way to do this is to use cedar tincture along with a vodka shell or tincture of lilac flowers.
To prevent the growth of bone tissue on the heel, it is necessary to avoid increased loads, wear comfortable shoes, and treat the pathologies of the musculoskeletal system in time. In adolescence, you need to regularly undergo a medical examination in order to detect this disease in time. Then it can be cured without complications.