Osteochondroma and multiple hereditary exostosis

Osteochondroma is a benign lesion that is derived from aberrant cartilage, typically appearing as a cartilaginous cap overlying a bony spur in the metaphysis of long bones. Spinal osteochondromas may be completely asymptomatic or may present with pain on palpation, a decreased spinal range of motion, or neurologic deficits. MRI is the imaging of choice in patients with spinal involvement, typically revealing lesions in the posterior elements of the vertebrae, including lamina, transverse processes, and spinous processes. Operative resection can be considered when patients have symptoms associated with mass effect or if the lesion is cosmetically unappealing. Patients with neurologic symptoms have good outcomes when the lesion is excised appropriately. There is a chance of recurrence following resection if osteochondromas are not completely excised.