Health-related quality of life and physical activity in children with Multiple Osteochondromas

To evaluate health-related quality of life (HRQOL) and physical activity level (PAL) in children and adolescents with Multiple Osteochondromas (MO) and to identify factors associated with these outcomes.

Cross-sectional survey of Dutch patients aged 4-18 years recruited through the national MO expertise center and the patient association. Validated, age-specific questionnaires assessed HRQOL (TAP/TAC/TAAQOL), PAL (Baecke), pain, functional disability, and psychosocial and sociodemographic variables. Multiple linear regression, guided by the International Classification of Functioning framework, examined associated variables with the mental and physical HRQOL components and with PAL.

A total of 134 participants (53% male; mean age ± SD, 11.4 ± 3.7 years) completed the survey. Compared with population norms, patients with MO scored significantly lower on physical HRQOL but not consistently lower on mental HRQOL. Significant gender differences emerged in specific HRQOL domains across multiple age groups. Mean PAL was also reduced (7.35 ± 1.01, p < 0.001) compared with healthy peers. Physical HRQOL (R² = 0.727, p < 0.001) was negatively associated with pain and positively with externalizing behavior. The mental HRQOL model (R² = 0.648, p < 0.001) showed the strongest negative associations with internalizing problems and functional disability. Having ≥ 5 surgeries was the only independent predictor of PAL, explaining 4.4% of its variance.

The pediatric MO population reports significantly lower physical HRQOL and PAL, but not consistently lower mental HRQOL than healthy peers. Specific gender differences were observed across multiple domains. The associations identified in this study call for a multidisciplinary approach to MO management that emphasizes pain control, functional rehabilitation, and psychosocial support.