The medical term exostosis (ICD code: M89.99) refers to a pathological bony outgrowth on the bone. The bony outgrowth is covered with cartilage mass. Exostosis is also commonly known as an overbone. Exostosis can occur on various bones in the human body.
Here you will find further information and selected exostosis specialists and centers.
The metatarsal bone and the back of the hand are particularly often affected.
Haglund's exostosis is a very common form of exostosis. In this case, part of the heel bone on the foot is particularly bulging. As a result, a bony protrusion develops in the area of the Achilles tendon insertion.
Cartilaginous exostosis, also known as osteochondroma, mainly occurs on the long tubular bones. This form of bone bulging occurs, for example, on the femur or humerus. The knee and ankle joint can also be affected.
If there are several bone bulges in these areas, they are referred to as multiple cartilaginous exostoses.
Other forms of exostoses include
Hallux valgus pseudoexostosis must be distinguished from the actual exostosis. This is not a real bone bulge, but merely a joint malposition. However, due to its shape, hallux valgus on the foot can easily be mistaken for a genuine exostosis.
Exostosis on the heel, the so-called Haglund exostosis © rob3000 | AdobeStock
The symptoms vary depending on the location and severity of the exostosis.
Sooner or later, Haglund's exostosis leads to Haglund's syndrome. It is characterized by
tendon. The main symptoms of Haglund's syndrome are stabbing pain in the heel bone, which is mainly caused by pressure or strain. The pain causes patients to walk with a limp.
Ear canal exostosis in the ear can cause symptoms such as
in the area of the ear canal.
Exostoses on the long bones can lead to
dislocations of the hip joint. The bone structures
in the immediate vicinity. This can lead to circulatory disorders and/or sensory disturbances.
In principle, several causes or risk factors can promote the formation of an exostosis.
Chronic pressure and irritation on the bone are often the cause. For example, shoes with less elastic edges can irritate the bone tissue. This favors the development of a Haglund heel.
Obesity is another risk factor for exostosis of the foot. In overweight people, the heel bone has to withstand a particularly heavy load.
Other diseases are also a risk factor, such as chronic joint wear and tear(osteoarthritis). Silverskjöld exostosis, for example, a bone bulge on the back of the foot, is usually caused by osteoarthritis.
The cause of osteochondroma is not yet fully understood. Genetic factors probably play a decisive role.
If an exostosis is suspected, the doctor usually carries out an X-ray examination. The bone changes are usually clearly visible on the X-ray. Computer tomography and magnetic resonance imaging are also suitable for further diagnosis.
X-ray image of an exostosis on a thigh bone © J. Lengerke - Praxis Dr. Jochen Lengerke, CC BY-SA 3.0 de, Link
Like the symptoms, the treatment depends primarily on the location and extent of the bone bulge.
Treatment can be conservative orthopaedic or surgical. The aim of the therapy is to alleviate the pain in the foot and improve the load-bearing capacity of the structure in everyday life and during sport.
Open shoes or insoles to raise the heel reduce the pressure on the exostosis and thus alleviate the pain. Anti-inflammatory and pain-relieving medication with active ingredients such as ibuprofen or diclofenac are used to support the treatment.
Physical therapies are also suitable for treating Haglund's exostosis. These include
If conservative methods do not help, surgery with removal of the exostosis may be useful.
The therapy includes
However, some people suffer from numerous, i.e. multiple exostoses. In this case, multiple operations are often necessary. Unfortunately, it is not always possible to achieve a satisfactory result in such cases.
In many cases, surgery for ear canal exostosis is associated with complications. For this reason, surgery is only used if symptoms occur regularly.
Recurrent inflammation of the ear canal would be an indication for surgery for ear canal exostosis.
The appearance and treatment options for exostosis are extremely varied. The following applies: the earlier the symptomatic bone protrusions are treated, the lower the risk of (permanent) sequelae.
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