The Prevalence and Severity of External Auditory Exostosis in Young to Quadragenarian-Aged Warm-Water Surfers: A Preliminary Study

External auditory exostosis (EAE) has previously only been shown to occur in cold water surfers. We assessed young surfers living and surfing in Queensland, Australia, for EAE in water temp ranges from 20.6 °C (69.1 °F, Winter) to 28.2 °C (82.8 °F, Summer). All participants underwent a bilateral otoscopic examination to assess the presence and severity of EAE. A total of 23 surfers participated with a mean age of 35.4 years (8.3 years) and a mean surfing experience of 20.0 years (9.9 years). Nearly two-thirds of participants (n = 14, 60.9%) had regular otological symptoms, most commonly water trapping (n = 13, 56.5%), pain (n = 8, 34.8%), and hearing loss (n = 6, 26.1%). Only 8.7% (n = 2) of all surfers reported regular use of protective equipment (e.g., earplugs) on a regular basis. The overall prevalence of exostosis was 69.6% (n = 16), and the majority (n = 12, 80.0%) demonstrated bilateral lesions of a mild grade (<33% obstruction of the external auditory canal). This is the first study assessing EAE in young surfers exposed to only warm waters (above 20.6 °C). The prevalence of EAE in this study highlights that EAE is not restricted to cold water conditions, as previously believed. Warm water surfing enthusiasts should be screened on a regular basis by their general medical practitioner and utilize prevention strategies such as earplugs to minimize exposure to EAE development

Chest pain caused by multiple exostoses of the ribs: A case report and a review of literature

Abstract The aim of this paper is to report an exceptional case of multiple internal exostoses of the ribs in a young patient affected by multiple hereditary exostoses (MHE) coming to our observation for chest pain as the only symptom of an intra-thoracic localization. A 16 years old patient with familiar history of MHE came to our observation complaining a left-sided chest pain. This pain had increased in the last months with no correlation to a traumatic event. The computed tomography (CT) scan revealed the presence of three exostoses located on the left third, fourth and sixth ribs, all protruding into the thoracic cavity, directly in contact with visceral pleura. Moreover, the apex of the one located on the sixth rib revealed to be only 12 mm away from pericardium. Patient underwent video-assisted thoracoscopy with an additional 4-cm mini toracotomy approach. At the last 1-year followup, patient was very satisfied and no signs of recurrence or major complication had occured. In conclusion, chest pain could be the only symptom of an intra-thoracic exostoses localization, possibly leading to serious complications. Thoracic localization in MHE must be suspected when patients complain chest pain. A chest CT scan is indicated to confirm exostoses and to clarify relationship with surrounding structures. Video-assisted thoracoscopic surgery can be considered a valuable option for exostoses removal, alone or in addiction to a mini-thoracotomy approach, in order to reduce thoracotomy morbidity

Multiple osteochondromas of the antlers and cranium in a free-ranging white-tailed deer (Odocoileus virginianus)

This paper reports a case of multiple osteochondromas affecting the antlers and the left zygomatic bone of a free-ranging adult white-tailed buck (Odocoileus virginianus) from Georgia, USA. Along with a few postcranial bones, the antlered cranium of the individual was found in a severely weathered condition and devoid of any soft tissue. The antlers exhibited five pedunculated exostoses that were composed of cancellous bone and, in their peripheral portions, also mineralized cartilage. The largest of the exostoses, located on the right antler, had a maximum circumference of 55 cm. The exostosis arising from the zygomatic bone was broad-based and much smaller than the exophytic outgrowths on the antlers. Diagnosis of the exostoses as osteochondromas was based on their overall morphology, the normal bone structure in their stalk regions, and the continuity of their spongiosa and cortex with the respective components of the parent bones. Antleromas, i.e., pathological outgrowths developing on antlers as a result of insufficient androgen production, were excluded in the differential diagnosis, based on (1) the apparent maturity and, except for the tumors, normal shape of the antlers and (2) the fact that exostosis formation had also affected the zygomatic bone. Previously only a single case of solitary osteochondroma of an antler has been described in the scientific literature. The case presented here is the first report of multiple osteochondromas in a deer. As antlers are regularly collected as trophies, and huge numbers of them are critically inspected each year, the fact that thus far only two cases of antler osteochondromas have been reported suggests that these tumors are very rare

Carnivora from the Sespe of the Las Posas Hills, California

The generic assemblage of carnivores known at present from the Kew Quarry of the Las Posas Hills, Ventura County, California, is perhaps most noteworthy because of its resemblance to that recorded from the John Day. Three members of the Canidae and two of the Felidae have been listed on the basis of skull remains. More detailed investigation of the structural characters of these types reveals a close specific similarity to comparable forms from the John Day. Indeed, one of the principal reasons for regarding the fauna from the Kew Quarry as closely related in time to that from the John Day beds of eastern Oregon is furnished by this kinship among the Carnivora. Although all of the carnivores are new to the Tertiary mammalian faunas of the Californian region, the skull material of Hoplophoneus possesses added interest, representing as it does the smallest sabre-tooth cat from North America. Surprising, to say the least, is this striking evidence that within the Tertiary faunal province of southern California occurred an early member of that great group of cats, of which one of the latest and most advanced stages of development is recorded so fully in the Pleistocene Smilodon of the asphalt deposits of Rancho La Brea

Osteochondroma of the proximal humerus with frictional bursitis and secondary synovial osteochondromatosis

We report a case of multiple hereditary exostosis in a 33-year old patient with clinical symptoms of pain and impression of a growing mass of the left shoulder alerting potential risk of malignant transformation of an osteochondroma. Imaging studies illustrated perilesional bursitis surrounding an osteochondroma of the proximal humerus. Malignant transformation was excluded with MRI. Fragments of the osteochondroma were dislocated in the inflammatory synovial bursa illustrating a case of secondary synovial osteochondromatosis

Patologías mandibulares en dos esqueletos de la Edad Media

X Congreso Nacional de Paleopatología. Univesidad Autónoma de Madrid, septiembre de 200

Targeted Disruption of Shp2 in Chondrocytes Leads to Metachondromatosis With Multiple Cartilaginous Protrusions

Metachondromatosis is a benign bone disease predominantly observed in the hands and feet of children or young adults demonstrating two different manifestations: a cartilage‐capped bony outgrowth on the surface of the bone called exostosis and ectopic cartilaginous nodules inside the bone called enchondroma. Recently, it has been reported that loss‐of‐function mutations of the SHP2 gene, which encodes the SHP2 protein tyrosine phosphatase, are associated with metachondromatosis. The purpose of this study was to investigate the role of SHP2 in postnatal cartilage development, which is largely unknown. We disrupted Shp2 during the postnatal stage of mouse development in a chondrocyte‐specific manner using a tamoxifen‐inducible system. We found tumor‐like nodules on the hands and feet within a month after the initial induction. The SHP2‐deficient mice demonstrated an exostosis‐like and enchondroma‐like phenotype in multiple bones of the hands, feet, and ribs as assessed by X‐ray and micro‐computed tomography (CT). Histological assessment revealed the disorganization of the growth plate cartilage, a cartilaginous protrusion from the epiphyseal bone, and ectopic cartilage nodules within the bones, which is consistent with the pathological features of metachondromatosis in humans (ie, both exostosis and enchondroma). At molecular levels, we observed an abundant expression of Indian hedgehog protein (IHH) and fibroblast growth factor 2 (FGF2) and impaired expression of mitogen‐activated protein kinases (MAPK) in the affected cartilage nodules in the SHP2‐deficient mice. In summary, we have generated a mouse model of metachondromatosis that includes manifestations of exostosis and enchondroma. This study provides a novel model for the investigation of the pathophysiology of the disease and advances the understanding of metachondromatosis. This model will be useful to identify molecular mechanisms for the disease cause and progression as well as to develop new therapeutic strategies in the future. © 2014 American Society for Bone and Mineral Research.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/106063/1/jbmr2062.pd

Arthroscopic management of an intraarticular osteochondroma of the hip.

The role of hip arthroscopy in the management of femoroacetabular impingement (FAI) has been advancing rapidly. In this case report, we describe the use of hip arthroscopy to successfully treat a femoral neck osteochondroma that caused a symptomatic labral tear in a 37 year old woman. Hip arthroscopy offers several advantages to surgical dislocation of the hip in the management of intraarticular pathology and FAI. Hip arthroscopy is minimally invasive without the significant trauma to hip musculature, is useful in treatment of labral tears generated by FAI, and can be used to resect small lesions on the femoral head

Infiltration of a biocompatible gel for the treatment of interdigital exostoses: A cadaveric study

Antecedentes. La exóstosis interdigital es una patología común que se presenta con frecuencia en las consultas de podología. A pesar del alto grado de incidencia es una entidad clínica muy poco estudiada. En la actualidad, los tratamientos propuestos para resolver esta patología son el tratamiento conservador mediante ortesis de silicona y el tratamiento quirúrgico consistente en la resección de la exostosis. Consideramos necesario otra alternativa de tratamiento que mejore la actividad diaria de los pacientes que presenten esta patología. Material y Métodos. Se procedió a la infiltración de un gel biocompatible en cadáver para simular de la forma más idónea posible la posterior aplicación clínica en pacientes. Se seleccionaron 10 pies de cadáver fresco, no formolado, con presencia de exostois a los que se realizó la infiltración del gel biocompatible siguiendo las instrucciones del fabricante. Resultados. Se observaron los siguientes aspectos: relación cantidad de producto/dimensiones obtenidas, edad de los especímenes, sexo, localización exostosis, cantidad de producto infiltrado, tipo de aguja, forma de infiltración, facilidad de la infiltración y distribución del producto. Conclusiones. La valoración de la técnica es positiva en el 100% de los casos, demostrando que el producto permanece in situ en la localización prevista, lo que nos hace concluir que puede ser un tratamiento válido para la exostosis interdigital.Precedents. Interdigital exostosis is a common pathology in podiatric surgery. Despite the rates of incidence, little has been researched on this clinical entity. Currently proposed treatments are: conservative treatment with silicone orthosis, and surgical treatment based on resection of exostosis. An alternative treatment to improve daily activity of patients with this pathology has been considered necessary. Material and Methods. Bio compatible gel was injected in a dead body in order to experiment and simulate the subsequent clinical application in patients. We selected 10 feet of fresh dead body, non-preserved in formaldehyde, with presence of exostosis, to which the bio compatible gel was injected following the established protocol and instructions provided by the manufacturer. Results. Aspects observed: relationship quantity of product / dimensions obtained, age of specimen, gender, location of exostosis, quantity of product injected, type of needle, injection procedure, ease of injection and allocation of product. Conclusion. The method is assessed as positive in 100% of studied cases, as the product remains in the predicted area, therefore we conclude that it is a suitable treatment for the interdigital exostosis