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Exostosis

Exostosis refers to a benign, bony outgrowth (bone growth) that often forms on the outer areas of a bone. Such outgrowths can occur singly or in multiples and are usually the result of maldevelopment of the bone, repeated mechanical irritation or a genetic predisposition. Exostoses are often discovered by chance, for example during x-rays taken for other reasons.

Causes and development

• Mechanical stimulus: Permanent pressure or tensile load (e.g. due to poorly fitting shoes or a malposition) can stimulate bone growth, which leads to the formation of an exostosis.
• Genetic factors: Certain forms of multiple exostoses (e.g. multiple cartilaginous exostoses) are due to a hereditary condition.
• Trauma or inflammation: Injuries or inflammatory processes can also contribute to excessive bone growth.

Localizations

• Foot: Bone deposits can form on the toes or on the heel bone (e.g. heel spur).
• Hand and fingers: Small, hard protrusions often form along the edges of the bones.
• Ribs and spine: In genetic forms, these areas can also be affected.

Symptoms

• Often no symptoms, especially if the exostosis is small and does not press on surrounding tissue.
• Mechanical irritation caused by shoes or movement can lead to pain, redness or inflammation.
• If the exostosis constricts nerves or blood vessels, discomfort or circulatory disorders may occur (although this is rare).

Diagnosis

• Clinical examination: Palpable bony protrusion under the skin; painful reaction to pressure or movement.
• Imaging: X-rays show characteristic bony protrusions. In more complex cases, an MRI or CT scan can be performed to assess the location and extent more precisely.

Treatment

• Conservative measures: If there is no pain or restricted movement, observation is often sufficient.
• Pain relief: Relieving footwear, insoles or pads can help to reduce the pressure on the affected area.
• Surgery: In cases of severe pain, inflammation or functional restrictions, the excess bone tissue is surgically removed.
• Physiotherapy: After an operation or in the case of minor complaints, exercises to relieve and stabilize the joint can be useful.

Conclusion: In most cases, an exostosis is harmless and does not cause any noticeable discomfort. In the case of painful or more pronounced changes, it is important to seek medical clarification in order to initiate suitable treatment - conservative or surgical. Early treatment can prevent exostosis from leading to loss of function or chronic pain.