Metachondromatosis: Difference between revisions

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{{more citations needed|date=June 2010}}
{{Infobox medical condition (new)  
{{Infobox medical condition (new)  
| name            = Metachondromatosis  
| name            = Metachondromatosis  
| synonyms        = METCDS
| image          = Autosomal dominant - en.svg  
| image          = Autosomal dominant - en.svg  
| caption        = Metachondromatosis has an autosomal dominant pattern of [[heredity|inheritance]].  
| caption        = Metachondromatosis has an autosomal dominant pattern of [[heredity|inheritance]].  
|
| pronounce      =  
| pronounce      =
| field          = [[Orthopedics]], [[Medical genetics]]
| field          =
| symptoms        = Multiple [[enchondromas]], [[osteochondromas]], bone pain, cranial nerve paralysis
| synonyms        =  METCDS<ref>{{cite web |title=Metachondromatosis {{!}} Genetic and Rare Diseases Information Center (GARD) – an NCATS Program |url=https://rarediseases.info.nih.gov/diseases/3560/index |website=rarediseases.info.nih.gov |accessdate=27 June 2019}}</ref>
| complications  = [[Avascular necrosis]], deformity, nerve damage
| symptoms        =  
| onset          = Typically in the first decade of life
| complications  =  
| duration        = Lifelong, with variable progression
| onset          =  
| duration        =  
| types          =  
| types          =  
| causes          =  
| causes          = [[PTPN11 gene]] mutations
| risks          =  
| risks          = Genetic predisposition, family history
| diagnosis      =  
| diagnosis      = Clinical evaluation, radiographic findings, genetic testing
| differential    =  
| differential    = [[Hereditary multiple osteochondromas (HMO)]]
| prevention      =  
| prevention      = Genetic counseling for at-risk families
| treatment      =  
| treatment      = Symptomatic management, surgical removal of lesions if necessary
| medication      =  
| medication      = Pain management
| prognosis      =  
| prognosis      = Generally good with appropriate treatment; may have cosmetic deformities
| frequency      =  
| frequency      = Rare, with limited documented cases
| deaths          =  
| deaths          = Uncommon, unless complicated by severe bone deformities or associated conditions
}}  
}}


=='''Alternate names'''==
== Alternate names ==
METCDS
* METCDS


=='''Definition'''==
== Definition ==
Metachondromatosis (MC) is a rare bone disorder characterized by the presence of both multiple [[Enchondroma|enchondromas]] and [[osteochondroma]]-like [[lesion]]<nowiki/>s.
Metachondromatosis (MC) is a rare [[genetic]] bone disorder characterized by the presence of both multiple [[enchondromas]] and [[osteochondroma]]-like [[lesions]]. The condition typically presents in childhood and can cause bone deformities and growth abnormalities.


=='''Cause'''==
== Cause ==
The condition has been linked to mutations in the '''PTPN11 gene''' in several families.
The condition has been linked to mutations in the '''[[PTPN11 gene]]''' in several families, which plays a role in the signaling pathways that regulate cell growth and differentiation.


=='''Inheritance'''==
== Inheritance ==
[[File:Autosomal dominant - en.svg|thumb|right|Autosomal dominant pattern, a 50/50 chance.]]
Metachondromatosis is inherited in an [[autosomal dominant]] manner, meaning an affected person has a 50% chance of passing the condition on to their offspring.
It is inherited in an [[autosomal dominant]] manner.


=='''Onset'''==
== Onset ==
The first signs occur during the first decade of life.
The first signs of metachondromatosis usually appear during the first decade of life, often before the age of 10.


=='''Signs and symptoms'''==
== Signs and symptoms ==
The symptoms of metachondromatosis are primarily due to the presence of multiple [[enchondromas]] and [[osteochondromas]]. Common symptoms include:


*Metachondromatosis (MC) is characterized by the presence of both multiple [[enchondroma]]<nowiki/>s and [[osteochondromas]].
* [[Enchondromas]]: Benign tumors that form inside the bones, often in the [[iliac crests]], [[femur]], and other long bones. These tumors are typically painless but can cause deformity when located in the [[hands]] and [[feet]].
*Enchondromas are benign (noncancerous) tumors that appear on the inside of the bone.
* [[Osteochondromas]]: Tumors that form on the surface of bones, typically near the growth plates. Most commonly found in the small bones of the hands and feet, these may cause bumps or discomfort if they press against soft tissues, nerves, or blood vessels.
*Those that are associated MC typically involve the iliac crests (part of the [[pelvis]]) and metaphyses of long bones, particularly the proximal [[femur]] (portion of the thigh bone closer to the trunk).
* Bone pain, particularly in the affected areas, such as the [[pelvis]] and [[long bones]].
*These [[tumors]] are usually painless, but when they appear in the hands or feet, or in multiple [[Lesion|lesions]] (as is typical in MC), they can deform the bone.
* Deformities in the [[hands]] and [[feet]] due to the growth of multiple tumors.
*Osteochondromas are also benign tumors. These form on the surface of the bone near the growth plates (areas of developing cartilage tissue near the ends of long bones in children) and are made up of both bone and cartilage. Osteochondromas may grow as the affected child grows, and stop growing when the child reaches skeletal maturity.
* [[Exostoses]]: New, benign bone growth on existing bone, which may lead to deformities.
*They have a tendency to regress or disappear after the first or second decade of life.
* [[Avascular necrosis]]: Death of bone tissue due to a lack of blood supply, which can cause pain and mobility issues.
*Those that are associated with MC most frequently occur in the small bones of the hands and feet, predominantly in digits and toes.
* [[Cranial nerve paralysis]]: Rare but may occur in severe cases.
*The characteristic location and orientation of these in individuals with MC (as well as lack of bone shortening and short stature) are what generally differentiate MC from hereditary multiple osteochondromas (HMO), a disorder with overlapping features.
*The osteochondromas of MC point toward the joint to which they are adjacent (whereas those of HMO point away).
*Osteochondromas often cause painless bumps, but pain or other discomfort may occur if the tumors put pressure on soft tissues, nerves, or blood vessels.


=='''Clinical presentation'''==
== Clinical presentation ==
For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed.
The clinical presentation varies, but typically includes the following:


80%-99% of people have these symptoms
80%-99% of people with MC exhibit:
* Abnormal epiphyseal morphology (altered shape of the end part of the bone)
* Abnormalities in the [[metaphysis]] (wide portion of long bones)
* [[Avascular necrosis]]
* Bone pain or tenderness
* [[Exostoses]] (benign bone growth)
* Multiple [[enchondromas]]


*Abnormality of epiphysis morphology(Abnormal shape of end part of bone)
== Diagnosis ==
*Abnormality of the metaphysis(Abnormality of the wide portion of a long bone)
The diagnosis of metachondromatosis is based on clinical evaluation, radiographic findings, and genetic testing. Characteristic radiological features include the presence of multiple [[enchondromas]] and [[osteochondromas]] in specific areas of the body, such as the [[iliac crests]], [[femur]], and hands or feet.
*[[Avascular necrosis]](Death of bone due to decreased blood supply)
*Bone pain
*Cranial nerve paralysis
*[[Exostoses]](Formation of new noncancerous bone on top of existing bone)
*Multiple [[enchondromatosis]]


=='''Diagnosis'''==
Genetic testing for mutations in the [[PTPN11 gene]] can confirm the diagnosis. A recent case report also described a family with radiographic features of both metachondromatosis and [[hereditary multiple osteochondromas]] (HMO), and a mutation of the EXT-2 gene, highlighting a potential overlap of these two disorders.


*Diagnosis is made based on the distribution and orientation of lesions; however, a recently published case report describes a family with radiographic features of both metachondromatosis and MO, and a mutation of EXT-2.<ref>Fisher, T. J., Williams, N., Morris, L., & Cundy, P. J. (2013). Metachondromatosis: more than just multiple osteochondromas. Journal of children's orthopaedics, 7(6), 455–464. https://doi.org/10.1007/s11832-013-0526-3</ref>.
== Treatment ==
Treatment is symptomatic and focused on managing pain and addressing deformities. Surgical removal of troublesome [[osteochondromas]] may be necessary if they cause pain or functional impairment. In some cases, [[physical therapy]] may help improve mobility and manage any musculoskeletal issues that arise due to the presence of bone tumors.


=='''Treatment'''==
Regular monitoring through [[radiographs]] is important to assess the progression of the condition and detect any new growths or changes in existing lesions. Pain management may include the use of nonsteroidal anti-inflammatory drugs (NSAIDs) or other analgesics.


==References==
== Prognosis ==
{{reflist}}
The prognosis for individuals with metachondromatosis is generally good with appropriate treatment, particularly for those without severe complications. However, cosmetic deformities and limited range of motion due to bone growths may occur. In severe cases, untreated bone deformities or complications such as [[avascular necrosis]] can lead to disability.
<references />


==External links==
== See Also ==
* [[Hereditary multiple osteochondromas (HMO)]]
* [[Enchondroma]]
* [[Osteochondroma]]
* [[Exostosis]]
 
== External links ==  
{{Medical resources
{{Medical resources
|   DiseasesDB     = 32116  
| DiseasesDB = 32116  
|   ICD10         = Q78.4
| ICD10 = Q78.4
| ICD9          = 
| OMIM = 156250
|  ICDO          =
| Orphanet = 2499
OMIM           = 156250  
|   MedlinePlus    =
|  eMedicineSubj  =
|  eMedicineTopic =
|  MeshID        =
Orphanet       = 2499
}}
}}
{{Deficiencies of intracellular signaling peptides and proteins}}
[[Category:Skeletal disorders]]
[[Category:Skeletal disorders]]
[[Category:Autosomal dominant disorders]]
[[Category:Autosomal dominant disorders]]
[[Category:Rare diseases]]
[[Category:Rare diseases]]
[[Category:Enzyme defects]]
[[Category:Enzyme defects]]
{{Genetic-disorder-stub}}
{{Genetic-disorder-stub}}

Latest revision as of 20:40, 2 April 2025

Metachondromatosis
Synonyms METCDS
Pronounce
Field Orthopedics, Medical genetics
Symptoms Multiple enchondromas, osteochondromas, bone pain, cranial nerve paralysis
Complications Avascular necrosis, deformity, nerve damage
Onset Typically in the first decade of life
Duration Lifelong, with variable progression
Types
Causes PTPN11 gene mutations
Risks Genetic predisposition, family history
Diagnosis Clinical evaluation, radiographic findings, genetic testing
Differential diagnosis Hereditary multiple osteochondromas (HMO)
Prevention Genetic counseling for at-risk families
Treatment Symptomatic management, surgical removal of lesions if necessary
Medication Pain management
Prognosis Generally good with appropriate treatment; may have cosmetic deformities
Frequency Rare, with limited documented cases
Deaths Uncommon, unless complicated by severe bone deformities or associated conditions


Alternate names[edit]

  • METCDS

Definition[edit]

Metachondromatosis (MC) is a rare genetic bone disorder characterized by the presence of both multiple enchondromas and osteochondroma-like lesions. The condition typically presents in childhood and can cause bone deformities and growth abnormalities.

Cause[edit]

The condition has been linked to mutations in the PTPN11 gene in several families, which plays a role in the signaling pathways that regulate cell growth and differentiation.

Inheritance[edit]

Metachondromatosis is inherited in an autosomal dominant manner, meaning an affected person has a 50% chance of passing the condition on to their offspring.

Onset[edit]

The first signs of metachondromatosis usually appear during the first decade of life, often before the age of 10.

Signs and symptoms[edit]

The symptoms of metachondromatosis are primarily due to the presence of multiple enchondromas and osteochondromas. Common symptoms include:

  • Enchondromas: Benign tumors that form inside the bones, often in the iliac crests, femur, and other long bones. These tumors are typically painless but can cause deformity when located in the hands and feet.
  • Osteochondromas: Tumors that form on the surface of bones, typically near the growth plates. Most commonly found in the small bones of the hands and feet, these may cause bumps or discomfort if they press against soft tissues, nerves, or blood vessels.
  • Bone pain, particularly in the affected areas, such as the pelvis and long bones.
  • Deformities in the hands and feet due to the growth of multiple tumors.
  • Exostoses: New, benign bone growth on existing bone, which may lead to deformities.
  • Avascular necrosis: Death of bone tissue due to a lack of blood supply, which can cause pain and mobility issues.
  • Cranial nerve paralysis: Rare but may occur in severe cases.

Clinical presentation[edit]

The clinical presentation varies, but typically includes the following:

80%-99% of people with MC exhibit:

Diagnosis[edit]

The diagnosis of metachondromatosis is based on clinical evaluation, radiographic findings, and genetic testing. Characteristic radiological features include the presence of multiple enchondromas and osteochondromas in specific areas of the body, such as the iliac crests, femur, and hands or feet.

Genetic testing for mutations in the PTPN11 gene can confirm the diagnosis. A recent case report also described a family with radiographic features of both metachondromatosis and hereditary multiple osteochondromas (HMO), and a mutation of the EXT-2 gene, highlighting a potential overlap of these two disorders.

Treatment[edit]

Treatment is symptomatic and focused on managing pain and addressing deformities. Surgical removal of troublesome osteochondromas may be necessary if they cause pain or functional impairment. In some cases, physical therapy may help improve mobility and manage any musculoskeletal issues that arise due to the presence of bone tumors.

Regular monitoring through radiographs is important to assess the progression of the condition and detect any new growths or changes in existing lesions. Pain management may include the use of nonsteroidal anti-inflammatory drugs (NSAIDs) or other analgesics.

Prognosis[edit]

The prognosis for individuals with metachondromatosis is generally good with appropriate treatment, particularly for those without severe complications. However, cosmetic deformities and limited range of motion due to bone growths may occur. In severe cases, untreated bone deformities or complications such as avascular necrosis can lead to disability.

See Also[edit]

External links[edit]

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