Bilateral Scapulothoracic Osteochondromas in a Patient With Hereditary Multiple Exostosis: A Case Report and Review of the Literature

Bilateral scapular osteochondroma in Multiple Hereditary Exostosis patient presented with bilateral shoulder pain treated with arthroscopic and open excision: Case report

Introduction and importance

Multiple etiologies for snapping shoulder syndrome have been described in the existing literature. Scapular osteochondroma is considered as a rare etiology and bilateral scapular osteochondroma have rarely been reported to date. Patient can present with discomfort, pain and crepitation. Multiple surgical methods were described and the patient underwent two different surgical methods with preferable outcome for arthroscopic side.

Case presentation

24 year-old male who is known case of Multiple Hereditary Exostosis (MHE) since childhood presented with bilateral shoulder pain and snapping scapula. Computed tomography demonstrated bilateral ventral scapular osteochondromas. One side treated with open excision and other side with arthroscopic excision.

Clinical discussion

Patient exhibited resolution of symptoms, restoration of function on both sides, but he reported cosmetic preference over arthroscopic side and faster recovery from surgery as well in terms of pain resolution and rehabilitation.

Conclusion

Osteochondroma should by one of differential diagnoses for snapping shoulder syndrome. Despite arthroscopic excision is technically demanding, it carries better outcome compared to open excision.

An unusual example of hereditary multiple exostoses: a case report and review of the literature

Background

Hereditary multiple exostoses (HME) is a rare skeletal disorder characterised by a widespread.

distribution of osteochondromas originating from the metaphyses of long bones.

Case presentation

This case study examines a 55-year-old male cadaver bequeathed to the University of Liverpool who suffered from HME, thus providing an exceptionally rare opportunity to examine the anatomical changes associated with this condition.

Conclusions

Findings from imaging and dissection indicated that this was a severe case of HME in terms of the quantity and distribution of the osteochondromas and the number of synostoses present. In addition, the existence of enchondromas and the appearance of gaps within the trabeculae of affected bones make this a remarkable case. This study provides a comprehensive overview of the morbidity of the disease as well as adding to the growing evidence that diseases concerning benign cartilaginous tumours may be part of a spectrum rather than distinct entities.