Subungual exostosis

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Subungual exostosis is a benign bone tumor that typically occurs beneath the nail bed of the toes or fingers. It is characterized by the growth of a bony projection, or exostosis, from the underlying phalanx bone. This condition is most commonly seen in the big toe but can affect any digit.

Presentation

Patients with subungual exostosis often present with pain, swelling, and deformity of the affected digit. The overlying nail may become elevated or deformed due to the underlying bony growth. In some cases, the lesion may ulcerate or become infected, leading to additional complications.

Etiology

The exact cause of subungual exostosis is not well understood. However, it is believed to be associated with repetitive trauma or chronic irritation to the affected area. Genetic factors may also play a role in the development of this condition.

Diagnosis

Diagnosis of subungual exostosis is typically made through clinical examination and X-rays. The X-ray will reveal a bony outgrowth from the distal phalanx, confirming the diagnosis. In some cases, additional imaging studies such as MRI or CT scan may be required to assess the extent of the lesion.

Treatment

Treatment options for subungual exostosis include conservative management and surgical intervention. Conservative management may involve protective padding, footwear modifications, and pain management. Surgical removal of the exostosis is often necessary for symptomatic relief and to prevent recurrence. The surgical procedure typically involves excision of the bony growth and repair of the nail bed.

Prognosis

The prognosis for patients with subungual exostosis is generally good following surgical removal. Recurrence is uncommon, and most patients experience significant relief of symptoms postoperatively.

See also

• Bone tumor
• Nail bed
• Phalanx bone
• Radiography