Exostosis
Osteon is the
basic cell element of the bone. Osteosis is meant the process of formation of
bone tissue. ‘Exostosis’ is medically meant for benign (non-cancerous) bone
tumour i.e., extra bone growth on a bony surface (here “exo” refers for
outward). Exostosis is otherwise called ‘Osteocartilaginous exostosis’ named
after its contents. Basically, it is a connective tissue tumour with
proliferation of bone tissue (lamellar osteon). It appears as a localised round
or oval hard bony mass with or without pain.
There are many things in the world which are less understood, one among them in
the medical world is exostosis. The reason for formation of extra bone in
exostosis still remains obscure. Most of the time, it seems / remains worthless
and creates nuisance with its pressure symptoms. This extra (?) bone formation
cannot be even related with complementary work of nature to provide extra
strength on requirement or to support. In case of fractures, union of fracture
ends will be attained with new bone formation – osteophyte formation.
These
ostephytes formations will also be seen in all deterioration process of bone
with infection or disease or strain or with improper friction, loss for
supporting the weakening tissues (bone tissues), for example – osteo arthritis,
ankylosing spondylitis. Here osteophytes formation occurs to support the
deteriorating bones. But in case of exostosis, there won’t be any infection or
friction loss or any other diseases to trigger the bone tissue to grow. In
spite of all this, exostosis seems to occur in the sufferer.
Incidence
Even
though it can occur in any age group, exostosis is most commonly seen in
adolescent females and people in the fourth decade. It is also commonly noted
in congenitally disabled persons.
Causes
Even
though injury, deformities, mechanical stress and strain with pressure changes
and change of postures or gait are claimed to be the cause, nothing has been
proven.
Common
sites
Exostosis can occur anywhere in the body, but
it is very commonly seen in toes, fingers, jaw, long bones, heel and scalp. It
can also arise inside the nasal sinus cavity, eye orbits, etc.
Types – It is often named according to the site(s) of origin.
- Subungal exostosis
are named for the exostosis which is often seen in the distal end of the
finger or toes under the nails. This is the commonest type. It often
mimics whitlow or nail bed infection. It can also cause deformity and
ulcerations.
- Buccal exostosis –
exostosis arising in oral cavity is named as buccal exostosis. It can be
seen both in the maxillary (upper jaw) or mandibular (lower jaw) area.
- Multiple exostosis –
is named for increased or increasing number of exostosis. It is mostly
seen in long bones especially the growing ends (especially in growth spurt
period). Studies reveal that it has a tendency to occur as hereditary.
It can also be classified as - Compact osteomas
(ivory osteomas) – hard nodes occuring in skull
Cancellour osteomas – for slender growths occuring in growing end of long bones - Diaphyseal aclasis –
for rare inherited multiple exostosis
Symptoms
Exostosis symptoms vary according to the site
and size. The common symptoms are
- Occurrence of round
/ oval dense bony hard protuberance on the surface of
bone(s)
- Slowly growing bony
mass or tubercle
- Single or may be
multiple in nature
- Discomfort and pain (rarely)
- Aggravation of pain
and discomfort on pressure or tight fittings
- Ulcers on the spot
of exostosis
Complications
When exostosis remains small, mostly there won’t be any complication at all.
But as it grows and gives pressure to adjacent nerves or vessles or muscles or
bones it causes complications. Complication usually varies according to the
site, involved structures and pressure intensity. Anyway, there need not be
fear of it transforming into cancer. If it compresses
- Nerve – it often
causes neuralgia (nervous shooting pains)
- Blood vessels –
causes reduced blood supply to distal organs which can cause cramps and
numbness
- Muscles – it can
cause cramps, fascitis (inflammation), etc.
- Bone – bone pain,
restriction of movement and sometimes even fracture may result
- Other than these,
exostosis can cause disfigurement and disability in severe cases.
Diagnosis
Any abnormal growth usually requires timely
professional advice / attention to root out the disease. Even though hard, firm
texture and immovable character confirms the swelling as exostosis, it is
better to fix diagnosis with X-ray or CT / MRI scan and rarely with biopsy
under the guidance of qualified professional. Presence of lamellar pattern with
fibro cartilagenous covering confirms the condition as exostosis. The covering
will be thin in case of matured one and thick in case of immature one (will be
replaced with dense bone tissue on maturity). In particular, it needs to be
ruled out from other serious malignant disorders or tumours.
General
treatment
In general, exostosis will be kept under
observation
or left untreated due to its harmless nature or without knowing what to do.
Doctors and patients opt for surgical removal, only when it disturbs
functionally and more cosmetically with its large size, since, even then, when
removed, arrest of recurrence in same spot or in a different spot cannot be
guaranteed. Surgical procedure involves shaving off the extra growth in bones
or excise it completely with surrounding bone tissues (since exostosis as such
will be hard). In addition, one should avoid tight-fitting shoes, repeated
stress and strain in same spot and avoid calcium supplements.
Homeopathic
Approach
Even
though nobody thinks of Homeopathy for exostosis, considering it as a pure
surgical disorder, Homeopathy can do wonders in cases of exostosis (in the
initial stages). Since surgical excision also cannot guarantee prevention of
new formation, it is better not to opt for surgery.
In Homeopathy, surgical removal of exostosis is considered the removal of
effects of the disease and not the removal of cause or disease itself.
Homeopathy treats the patient (not disease) by enhancing his/her immune
mechanism to expel the disease as such on its own. This enhancement of immune
mechanism further prevents new formation or recurrence.
In
Homeopathy, treatment should be started as early as possible to arrest the
growth of the exostosis and get disappearance or reduction in size. It will be
easy to treat exostosis in the immature stage where exostosis has minimal core
bone covered with thick fibrous cartilaginous sheath. Here exostosis can be
made to disappear or reduced in size to near normal. In the case of matured
exostosis, most of the cartilaginous material will be replaced with dense bone
tissues leaving a thin cartilaginous sheath as cover. Here Homeopathic
treatment could not help in making it vanish or reduce its size due to hard
structural deformity, but can only provide arrest of further growth.
Homeopathic medicines commonly used in case of exostosis are Acid flour,
Anti-crud, Asafoetida, Calc carb, Calc fluor, Calc Phos, Colchicum, Hecla lava,
Mezereum, Natrum Mur, Phosphorus, Radium brom, Rhus tox, Ruta, Silicea,
Sulphur, Symphytum. Thuja etc. These medicines should be taken under the advice
and diagnosis of a Qualified Homoeopath.
for new hope
Dr. S. Chidambaranathan, BHMS, MD (Homeo)
Laxmi Homeo Clinic
24 E. New Mahalipatti Road
Madurai, TN 625 001
India
Tel: +91-984-319-1011 (Mob /
Whatsapp)
Clinic : +91-452-233-8833 |
E-mail: drcheena@gmail.com
(Disclaimer -
The contents of this column are for informational purpose only. The content is
not intended to be a substitute for professional healthcare advice, diagnosis,
or treatment. Always seek the advice of healthcare professional for any health
problem or medical condition.)