Hereditary multiple exostoses of the hip

Area of Science:

• Orthopedics
• Radiology
• Genetics

Background:

• Hereditary multiple exostoses (HME) is a genetic disorder characterized by the development of multiple osteochondromas.
• Hip involvement is common in HME, potentially leading to significant morbidity.

Purpose of the Study:

• To evaluate the radiographic features of hips in patients with hereditary multiple exostoses (HME).
• To identify common radiographic abnormalities associated with HME of the hip.

Main Methods:

• Anteroposterior radiographs of 36 hips from 18 patients (2-28 years old) with HME were analyzed.
• Key parameters assessed included osteochondroma location, femoral head/neck ratio, Reimer's migration percentage, Sharp's acetabular angle, centre edge angle, femoral neck-shaft angle, and degenerative changes.

Main Results:

• Osteochondromas were most frequent in the femur and ilium; only one was intra-articular.
• Common radiographic findings included coxa valga (32 hips), abnormal Reimer's migration percentage (26 hips), abnormal Sharp's acetabular angle (17 hips), abnormal centre edge angle (12 hips), abnormal femoral neck-shaft angle (32 hips), and degenerative changes (6 hips).
• Acetabular and femoral dysplasia, along with hip subluxation, are prevalent in HME.

Conclusions:

• Hips with borderline subluxation, significant coxa valga, or acetabular dysplasia require close monitoring for potential future surgical intervention.
• Early surgical management is advised for subluxated hips, particularly in pediatric and symptomatic adult populations.