Presentation
A 18-year-old man presented with a lump, ulceration, and pain on his right big toe. This complaint was present for the past 2 years. Initially, lump and pain were present, and since the past 6 months ulceration and superadded infection occurred. [ncbi.nlm.nih.gov]
Entire Body System
- Pain
Pain relief was complete, thereafter, and after 2 years of postoperative follow-up the patient remained pain free. [ncbi.nlm.nih.gov]
Taking anti-inflammatory medications such as Naproxen may help with painful symptoms. [medicalnewstoday.com]
- Asymptomatic
These benign tumors can be asymptomatic or manifest when a complication arises. Urogenital manifestations have been described exceptionally [ 5, 6, 7, 8 ]. [em-consulte.com]
We report a case of a 21-year old male with an asymptomatic solitary costal exostosis incidentally detected on a chest X-ray. The exostosis originated from the costochondral junction of the left fourth rib and protruded into the thoracic cavity. [ncbi.nlm.nih.gov]
There is no risk of malignant transformation, and thus no treatment is required in asymptomatic cases. [jbsr.be]
- Surgical Procedure
Hemiepiphysiodesis, a surgical procedure affecting the growth plates, may be done in the lower extremities and wrist to correct any misalignment of the bones during future growth. [hopkinsmedicine.org]
These results suggest that resection of the dorsal exostosis deformity of the metatarsocuneiform joints is an effective surgical procedure for patients with this deformity. Copyright © 2016 American College of Foot and Ankle Surgeons. [ncbi.nlm.nih.gov]
Given the increased risk of adverse side effects secondary to surgical procedures, it is necessary to construct an agreeable plan to refrain from osteochondroma removal unless medically necessary. [hindawi.com]
- Inflammation
Very often there is no origin or etiology related to these bumps; however, it has been related to mild inflammation in the periosteum or jaw bone. [colgate.com]
The patient may be given a prescription for an oral NSAID or steroids, to help in lessening inflammation. Pain gels and pain patches can also be applied to the heel. [medhealthdaily.com]
They can also occur because of short or tight Achilles tendon, inflamed pad, bursitis, inflammation, Haglund’s deformity, or Achilles tendonitis. [mddk.com]
Reduction of the inflammation and pain can be achieved by treating the area with a daily regimen of ice therapy and the use of anti-inflammatory medications (NSAID’s). [footanklespecialtygroup.com]
- Localized Pain
This can lead to localized pain. People with hereditary multiple exostoses are usually diagnosed by the age of 5 years old. They may experience no symptoms or extreme symptoms, such as visibly abnormal bone shapes. [medicalnewstoday.com]
Gastrointestinal
- Vomiting
There was no history of swimming, trauma, dizziness, vomiting, visual disturbance and neurological deficit. On examination, the swelling was found to arise from the posterior wall of the external auditory canal. [ispub.com]
Musculoskeletal
- Fracture
Expedient stabilization of unstable pelvic fractures has been shown to significantly reduce morbidity and mortality in the polytrauma patient. Application of a pelvic external fixator is one of the methods used to provide effective pelvic stability. [ncbi.nlm.nih.gov]
Key words: Calcaneus, fracture, complications, plantar exostosis, exostectomy, subtalar arthrodesis. [faoj.org]
Trauma: fractures. Investigations Plain X-ray - may be the only imaging study required. CT scan - useful in the assessment of osteochondromas in the pelvis, shoulder or spine. [patient.info]
- Heel Pain
Effectiveness of dry needling and injections of myofascial trigger points associated with plantar heel pain: a systematic review.. Journal of foot and ankle research, 3, 18. DiResta, J. (2006). [gelenk-klinik.de]
Abnormality of the calcaneus as a cause of painful heel: its diagnosis and operative treatment. Br J Surg 32:494-498, 1945. 6. Sundberg SB, Johnson KA. Painful conditions of the heel. [podiatrytoday.com]
Range of motion at the subtalar joint was restricted and painful with increased heel width and no varus or valgus deformity of heel. [faoj.org]
- Foot Pain
Lumps and Bumps in the Ball of the Foot Painful lumps in the ball of the foot are usually but not always associated with a thickening of the skin or callus. [podiatrynetwork.com]
Ears
- Tinnitus
The tinnitus gets better when the patient turns the head/neck to the right or perform a hand compression of the neck in the right carotid. The tinnitus follows the cardiac rhythm and gets worse when she practices exercises. [elsevier.es]
Most patients present with unilateral hearing loss, pain, and tinnitus due to impacted cerumen secondary to the narrowing of the lumen of the external auditory meatus, although radiologically, findings are almost always bilateral. [neurologyindia.com]
Dizziness, vertigo, worsening of the preoperative air-bone gap, tinnitus and diminished sense of taste have also been reported[19,27,29,31,32,38-40]. [wjgnet.com]
Surgery, University of California, Irvine, School of Medicine Jack A Shohet, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Medical Association, American Neurotology Society, American Tinnitus [medscape.com]
Psychiatrical
- Fear
It is suggested to refrain from surgery until individuals with HME achieve skeletal maturity for fear of recurrence in the skeletally immature patient. [hindawi.com]
Rock climbing left me with two bad feet, one very, very near death experience, and an irrational fear of heights. [sprinterlife.com]
Besides cosmetic disfigurement and pain, the primary indication for surgical excision was the fear of developing a malignant growth in view of the ulcerating margins. [jotr.in]
Other less frequent but more feared complications reported in the literature are damage to the temporo-mandibular joint or the facial nerve, sensorineural hearing loss, cervical subcutaneous emphysema and petrositis[43,44,46]. [wjgnet.com]
Neurologic
- Dizziness
Beko also offers advanced vestibular rehabilitative therapy to improve balance and resolve or reduce dizziness. Don't "just live with" dizziness, unsteadiness, reduced hearing or ear discomfort. [ear-hearing-doctors.com]
There was no other symptoms, such as hypoacusis, dizziness, or pain, and the patient had no previous medical history. Physical examination had no abnormalities. [elsevier.es]
There was no history of swimming, trauma, dizziness, vomiting, visual disturbance and neurological deficit. On examination, the swelling was found to arise from the posterior wall of the external auditory canal. [ispub.com]
Dizziness, vertigo, worsening of the preoperative air-bone gap, tinnitus and diminished sense of taste have also been reported[19,27,29,31,32,38-40]. [wjgnet.com]
- Headache
"I was in and out the same day, had muffled hearing, throbbing and headaches for a couple of days, then was back to business as usual in four to five days, except for getting back in the water right away. I'm very happy with the procedure and Dr. [pamf.org]
She only complained of a mild headache in the right temporal area, that occurs occasionally and gets better with analgesics. The audiogram showed no alterations in relation to the previous exam, maintaining a normal tympanometry (type A bilateral). [elsevier.es]
The patient gave history of intermittent headache and hearing impairment. There was no history of swimming, trauma, dizziness, vomiting, visual disturbance and neurological deficit. [ispub.com]
- Vertigo
[…] canal (IAC).1,2 There are not many cases described in the literature, Pubmed presents only 14 manuscripts.3 The clinical presentation of internal auditory canal exostoses varies, most cases are asymptomatic, but in some cases they can cause tinnitus, vertigo [elsevier.es]
Dizziness, vertigo, worsening of the preoperative air-bone gap, tinnitus and diminished sense of taste have also been reported[19,27,29,31,32,38-40]. [wjgnet.com]
Workup
Radiography of the digit is a noninvasive test that should be part of the initial workup whenever subungual exostosis is in the differential diagnosis. [ncbi.nlm.nih.gov]
Treatment
Share on Pinterest While treatment is often unneccesary, surgery may be required in the case of severe exostosis. In many cases, no treatment is necessary. [medicalnewstoday.com]
Prognosis
What patient characteristics are associated with better prognosis? What disease characteristics are associated with better prognosis? Methods : We searched the literature using three major databases with no publication date restrictions. [doi.org]
Prognosis The prognosis depends on the development of complications. Spontaneous resolution of osteochondromas during childhood and puberty is rare but has been described. [patient.info]
Cartilaginous Exostosis Prognosis This disease does not carry a deadly prognosis. However, the onset of cartilaginous exostosis can lead to serious health complications for the patient. [knowcancer.com]
What is the Prognosis of Subungual Exostosis? (Outcomes/Resolutions) With appropriate treatment, the prognosis of Subungual Exostosis is typically excellent, since the tumors are benign in nature The risk of recurrence is related to surgery. [dovemed.com]
The prognosis is very good if surgically excised, and as with all growths or masses, a biopsy should be obtained to rule out a more serious condition. [lifootcare.com]
Etiology
Hereditary/surgery Gait Disorders, Neurologic/etiology Humans Magnetic Resonance Angiography Male Peroneal Neuropathies/diagnosis Peroneal Neuropathies/etiology* Popliteal Artery*/diagnostic imaging Popliteal Artery*/surgery Tomography, X-Ray Computed [ncbi.nlm.nih.gov]
Etiology Although heredity is an acknowledged etiologic factor in exostosis, only four of the patients gave or admitted a positive history of this condition in the family. Twelve gave a history of arthritis; other incidental diseases were rare. [pubs.rsna.org]
Epidemiology
Epidemiological aspects of oral tori in a Ghanaian community. Int Dent J 2004; 54: 78–82. [nature.com]
Clinical and retrospective epidemiological surveys have revealed a strong positive correlation between EAE development and habitual exposure to cold water. [ncbi.nlm.nih.gov]
Epidemiology Affects 2 per 100,000 population. [ 2 ] More frequently found in Caucasians than in other races. Risk factors Inheritance is autosomal dominant, with near-complete penetrance. [patient.info]
Design Cross-sectional epidemiological study. Setting General community. Patients Three hundred seven avid surfers (93.5% males and 6.5% females; age distributions: 11.2% were ≤20, 67.9% were 21 to 40, 17.5% were 41 to 50, and 3.3% were >50 years). [jamanetwork.com]
Tavares G, Di-Chiacchio N, Di-Santis E, Alvarenga L, Stuhr P, de-Farias D, Tosti A, Di-Chiacchio NG: Onychomatricoma: epidemiological and clinical findings in a large series of 30 cases. Br J Dermatol 2015;173:1305-1307. [karger.com]
Pathophysiology
The pathophysiology is not clearly understood, but the lesion has base of trabecular bone with a proliferating fibrocartilaginous cap. Teriparatide can stimulate the trabecular bone formation. [ncbi.nlm.nih.gov]
Etiology and pathophysiology The pathogenesis of subungual exostosis is unknown, but current theories include trauma, infection, tumor, hereditary abnormality, or activation of a cartilaginous cyst. [dermatologyadvisor.com]
Symptoms are more likely to be severe if the mutation is on the ext1 gene rather than ext2 or ext3; ext1 is also the most commonly affected gene in patients of this disorder.[14] Pathophysiology[edit] It is characterized by the growth of cartilage-capped [en.wikipedia.org]
Whether the neoplasm is sessile or pedunculated, the medullary canal of the stalk and the bone are in continuity by definition. [5] Pathophysiology Osteochondroma is a hamartoma, and patients most commonly present in the second decade of life. [emedicine.medscape.com]
Prevention
[…] tumor recurrence, a preventive measure to follow for surgery on any exostosis location. [em-consulte.com]
IS EXOSTOSIS PREVENTABLE? Exostosis is preventable by following some basic safety precautions. [californiaearinstitute.com]
The curative treatment for a subungual exostosis is complete excision, and the cartilaginous cap must be totally resected to prevent a possible recurrence. [ncbi.nlm.nih.gov]
Treatment and prevention The use of earplugs while swimming in cold water or protecting the ears while out in cold wind can help prevent exostoses developing. [specsavers.com.au]