Spinal osteochondroma presenting as atypical spinal curvature: a case report

The case of an 8-year-old girl with hereditary multiple exostosis presenting with atypical spinal curvature is reported. To describe a case of spinal curvature caused by an osteochondroma, illustrating the need for careful evaluation of patients with hereditary multiple exostosis presenting with "scoliosis." Osteochondromas have been known to arise in the spinal canal and to present with symptoms of neural compression. Spinal curvature is a rare presenting sign of osteochondromas. The patient's medical and radiographic history is reviewed as well as the medical literature. An 8-year-old girl with hereditary multiple exostosis was referred for possible thoracotomy and anterior decompression of a T4 osteochondroma thought to be causing an atypical "scoliosis." Further examination, review of the radiographs, and computed tomography scan showed a large L4 osteochondroma encroaching on the neural elements. The patient's neurologic symptoms and spinal curvature resolved in the 2 years after surgical excision of the lumbar osteochondroma. Patients with hereditary multiple exostosis and spinal curvature require further diagnostic evaluation to ensure that an osteochondroma in the spinal canal is not the cause of that curvature.