Interphalangeal osteochondromatosis

Abstract

The etiology and pathogenesis of osteochondromatosis is still uncertain. From the histological study and its clinical evolution, it can be classified as a new formation of benign character from a metaplasis distinctly different from an arthritic alteration. As a summary of the published cases, the most salient features are reported as follows: The disease is noted in young, robust individuals in 50 per cent of whom there is a slight history of trauma. It is very slow in its course, latent, and unrecognized by the patient until very late, when there is pain or functional disturbances. It is usually monoarticular and has a particular predilection for the large joints such as the knee and the elbow. The osteocartilaginous bodies can be present at the same time in the articular bursae. They have been found also in the tendon sheaths of the flexor group of the hand. The joint is full of bodies of different sizes and shapes. The synovial membrane is hyperemic and covered with fibrous exudate. The bony extremity is almost always intact. The histological examination in this case revealed three distinct steps in its formation: 1. (1) Hypertrophic and hyperemic villi 2. (2) Villi transformed into pedunculated bodies 3. (3) Loose bodies. Breuckman, as we have said, believes that these formations become secondarily pedunculated and become ossified either by the fluid or the membrane.