Subungual exostosis
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Subungual exostoses are benign osteocartilaginous tumours which occur beneath the nail bed.
Epidemiology
These lesions are most commonly found in children and young adolescents 1-2.
Clinical presentation
Although they can be found beneath any nail, they most commonly affect the big toe 1-2. In the majority of cases patients are able to give a history of trauma or infection to the affected toe 3. Presentation is usually with pain and swelling. There may be ulceration of the overlying nail 3.
Pathology
Subungual exostoses probably result from metaplasia in mechanical irritations or diseases of the nailbed although the precise aetiology is unknown 2. The lesion is composed of mature fibrocartilagnious tissue and bone and resembles callus1,3.
Radiographic features
These lesions are osseous although in some cases they can grow very rapidly and mimic a sarcoma 3. They are almost invariably connected to the underlying bone. Although usually appear as well circumscribed bone, they lack a clear continuity of both the medullary cavity and cortex, which helps to distinguish them from osteochondromas.
Treatment and prognosis
These lesions are benign. Resection of the exostosis and curettage of the underlying bone is curative 1.
Differential diagnosis
- osteochondroma: cortex and medullary cavity continuous with lesion
- Nora's lesion (BPOP)
- osteosarcoma
- subungual osteogenic melanoma
On radiographs consider
See also
-<p><strong>Subungual exostoses </strong>are benign osteocartilaginous tumours which occur beneath the nail bed. </p><h4>Epidemiology</h4><p>These lesions are most commonly found in children and young adolescents <sup>1-2</sup>. </p><h4>Clinical presentation</h4><p>Although they can be found beneath any nail, they most commonly affect the big toe <sup>1-2</sup>. In the majority of cases patients are able to give a history of trauma or infection to the affected toe <sup>3</sup>. Presentation is usually with pain and swelling. There may be ulceration of the overlying nail <sup>3</sup>. </p><h4>Pathology</h4><p>Subungual exostoses probably result from metaplasia in mechanical irritations or diseases of the nailbed although the precise aetiology is unknown <sup>2</sup>. The lesion is composed of mature fibrocartilagnious tissue and bone and resembles callus<sup>1,3</sup>. </p><h4>Radiographic features</h4><p>These lesions are osseous although in some cases they can grow very rapidly and mimic a sarcoma <sup>3</sup>. They are almost invariably connected to the underlying bone. Although usually appear as well circumscribed bone, they lack a clear continuity of both the medullary cavity and cortex, which helps to distinguish them from <a href="/articles/osteochondroma" title="Osteochondroma">osteochondromas</a>. </p><h4>Treatment and prognosis</h4><p>These lesions are benign. Resection of the exostosis and curettage of the underlying bone is curative <sup>1</sup>. </p><h4>Differential diagnosis</h4><div style="background-image: initial; background-attachment: initial; background-origin: initial; background-clip: initial; background-color: rgb(240, 240, 240); ">-<ul style="font-family: Arial, Helvetica, sans-serif; font-size: 12px; font-style: normal; font-variant: normal; font-weight: normal; line-height: 1.5; ">- +<p><strong>Subungual exostoses </strong>are benign osteocartilaginous tumours which occur beneath the nail bed. </p><h4>Epidemiology</h4><p>These lesions are most commonly found in children and young adolescents <sup>1-2</sup>. </p><h4>Clinical presentation</h4><p>Although they can be found beneath any nail, they most commonly affect the big toe <sup>1-2</sup>. In the majority of cases patients are able to give a history of trauma or infection to the affected toe <sup>3</sup>. Presentation is usually with pain and swelling. There may be ulceration of the overlying nail <sup>3</sup>. </p><h4>Pathology</h4><p>Subungual exostoses probably result from metaplasia in mechanical irritations or diseases of the nailbed although the precise aetiology is unknown <sup>2</sup>. The lesion is composed of mature fibrocartilagnious tissue and bone and resembles callus<sup>1,3</sup>. </p><h4>Radiographic features</h4><p>These lesions are osseous although in some cases they can grow very rapidly and mimic a sarcoma <sup>3</sup>. They are almost invariably connected to the underlying bone. Although usually appear as well circumscribed bone, they lack a clear continuity of both the medullary cavity and cortex, which helps to distinguish them from <a href="/articles/osteochondroma">osteochondromas</a>. </p><h4>Treatment and prognosis</h4><p>These lesions are benign. Resection of the exostosis and curettage of the underlying bone is curative <sup>1</sup>. </p><h4>Differential diagnosis</h4><p>On radiographs consider</p><ul>
-<a href="/articles/osteochondroma" title="Osteochondroma">osteochondroma</a>: cortex and medullary cavity continuous with lesion</li>-<li><a href="/articles/bizarre_parosteal_osteochondromatous_proliferation" title="Bizarre parosteal osteochondromatous proliferation">Nora's lesion (BPOP)</a></li>-<li><a href="/articles/osteosarcoma" title="Osteosarcoma">osteosarcoma</a></li>-<li><a href="/articles/subungual-osteogenic-melanoma" title="subungual osteogenic melanoma">subungual osteogenic melanoma</a></li>-</ul>-<h4>See also</h4>-<ul><li><a href="/articles/exostosis" title="Exostosis">exostosis</a></li></ul>-</div>- +<a href="/articles/osteochondroma">osteochondroma</a>: cortex and medullary cavity continuous with lesion</li>
- +<li><a href="/articles/bizarre-parosteal-osteochondromatous-proliferation">Nora's lesion (BPOP)</a></li>
- +<li><a href="/articles/osteosarcoma">osteosarcoma</a></li>
- +<li><a href="/articles/subungual-osteogenic-melanoma">subungual osteogenic melanoma</a></li>
- +</ul><h4>See also</h4><ul><li><a href="/articles/exostosis">exostosis</a></li></ul>
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