Osteochondroma (Exostosis) | Diagnosis & Treatments


How are osteochondromas in children diagnosed?

In addition to a complete medical history and a full physical examination, the procedures for diagnosing osteochondroma in children may include:

  • X-ray: In almost all cases, an osteochondroma can be diagnosed using an x-ray. An x-ray uses a small amount of radiation to produce pictures of a child’s bones and organs. This helps to determine where the growth is located. Osteochondromas show up on the x-ray as a hard mass near the growth plate on a normal bone, which makes most easy to detect.

The following diagnostic tests are usually not required, except if the tumor is found in an unusual location, such as the pelvis:

  • Magnetic resonance imaging (MRI): a diagnostic procedure that uses a combination of large magnets, radio frequencies, and a computer to produce detailed images of organs and structures within the body. This test is particularly useful in identifying tumors in areas that are difficult to image on a plain X-ray. It also helps confirm the size of the tumor and distinguish it from other types of bone tumors.
  • Computerized tomography scan (also called a CT or CAT scan): a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce images, both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.
  • Bone scans: a nuclear imaging method to detect bone diseases, tumors, and inflammation. In rare cases, this is used to check for other osteochondromas in children with multiple hereditary exostoses (MHE).

How are osteochondromas in children treated?

Osteochondromas that are not painful or likely to cause a fracture don't require treatment.

Complications that can occur with surgery to remove this kind of tumor (or tumors) factor in to a decision to leave the tumor alone. For example, if an osteochondroma occurs in close proximity to the bone's growth plate, surgical interference in the area could affect how the bone grows.

The child should continue to be seen by a doctor, since a very small number of osteochondromas (1 percent) can develop into cancerous (malignant) tumors. In the rare circumstance that this occurs, it is almost always in adulthood and is usually notable for growth in size of a lump or pain in a previously painless lump.

When is surgery needed?

Your child's physician may recommend surgery if your child is experiencing pain, fracture, or nerve irritation, or if the tumor is large or bothersome.

In cases where surgery is necessary, the treatment of choice is complete removal of the tumor. This involves opening the skin over the tumor, locating the osteochondroma, and cutting it off of the normal bone. Depending on the location of the osteochondroma, surgical removal of the lesion is usually successful. However, if the tumor is close to nerves and blood vessels, the operation can be more difficult.

In cases where the genetic disorder, multiple hereditary exostoses (MHE), causes multiple lesions, and in very young children, there is a very small chance (5 percent) that new tumors may form in the same area after they are removed with surgery.