A Unique Case of Asymptomatic Osteochondroma From the Rib in Multiple Hereditary Exostoses: Insights Into Screening and Management.

CASE: A 10-year-old girl with Multiple Hereditary Exostoses (MHE) had a whole spine screening MRI, which revealed a large asymptomatic costovertebral osteochondroma causing spinal cord impingement. She had an en bloc resection, laminectomy of T4, and T3 to T5 posterior instrumented spinal fusion. At the 1-year follow-up, she remained asymptomatic.

CONCLUSIONS

Costovertebral osteochondromas are rare and typically discovered once they become symptomatic. This case highlights the value of spinal screening MRIs in children with MHE, emphasizing the need to develop screening protocols and establish guidelines for managing asymptomatic spinal osteochondromas.

LEVEL OF EVIDENCE: V.