left Femur and Tibia Exostosis

1. LEFT FEMUR &TIBIA
EXOSTOSIS
Case Presentation
on

2. Demographics
• NAME: N.Priyanka
• HP no:MH0031291
• AGE : 13yrs
• SEX : Female
• DOA:24/10/2018

3. ReasonS for admission
 Swelling and pain in left leg above the knee joint since 2 years.
 Swelling gradually increasing in size.

4. PMHx
No past medical history.
• PERSONAL HISTORY:
APPETITE-Good
BOWELS-Free

5. Physical examination, Systemic Examination
•Pulse : 82 beats / min
•Respiration Rate : 20 Breaths/min
•SpO2:100%
•O/E :Exostosis left Femur and Tibia

6. problem list
LEFT FEMUR &TIBIA EXOSTOSIS

7. Summary of Pharmaco-therapy:
S.NO DRUG DOSE FRQ ROA D1 D2
1 Inj.Taxim (CEFOTAXIME) 1gm BD IV  
2 Inj.Voveran (DICLOFENAC) 1amp
(75mg)
BD IM  
3 Inj.Kipinex forte
(CEFOPERAZONE SODIUM 1gm +
SULBACTUM500 mg)
1.5gm IV 
4 Inj.Justin (DICLOFENAC) 75mg IM 

8. PHARMACEUTICAL CARE PLAN:
Subjective Evidences
Swelling and pain in left leg above the knee joint since 2
years.
Swelling gradually increasing in size.

9. Objective Evidences:
•Pulse : 82 beats / min
•Respiration Rate : 20 Breaths/min
•SpO2:100%
•O/E :Exostosis left Femur and Tibia.
Lab Details :
•Sr.creatinine-0.40mg/dl
•Hb-11.2g/dl
•RDW-16.8%
•Eosinophils-14.0%
X-Ray pelvis with both Hips:
Imp:Multiple Osteochondromas noted at lower 1/3rd of
left femur and upper 1/3rd of left tibia.

10. Assessment
Etiology:
• Heriditary
Risk Factors:
• Family history of HME
• Age (teenagers)

11. Complications:
• Extreme pain, nerve damage, and the presence of
weak bones.
• Formation of malignant bone tumors called
chondrosarcomas.
• Recurrence of the exostoses after surgery.
• Damage of vital nerves, blood vessels, and
surrounding structures.
Goals of therapy:
• To increase the serum creatinine levels
• To decrease the pain & swelling
• To decrease the Eosinophils & RDW

12. PLANNING
•Treatment for hereditary multiple exostosis may include
surgery to remove the bony growths.
•To treat the pain NSAIDS are given.

13. About disease:
EXOSTOSIS:An exostosis,also known as bone spur, is
theformation of new bone on the surface of a bone.
PATIENT COUNSELLING

14. Life style Modification
• Consult the doctor if you experience any undesirable side
effects.
• Ensure that the treatment course is completed.
• Do not stop the use of medicines without consulting the
doctor.
• Regular exercise
• Do not exert much pressure on the joints.

15. References
• https://www.google.com/search?q=exostosis+definition+medical&
source=lnms&sa=X&ved=0ahUKEwiLy9DEgIHhAhVZbysKHdf
fBhwQ_AUICSgA&biw=1440&bih=789&dpr=1
• https://radiopaedia.org/cases/femoral-exostosis
• https://www.healthline.com/health/exostosis
• www.dovemed.com/.../hereditary-multiple-exostoses
• https://www.hopkinsmedicine.org/healthlibrary/conditions/pediat
rics/hereditary_multiple_exostosis_22,HereditaryMultipleExostos
is
• https://www.google.com/search?q=surgical+procedure+for+exost
osis+in+femur&source=lnms&tbm=isch&sa=X&ved=0ahUKEwj
n_rjLi5PhAhXHV30KHactDh0Q_AUIDigB&biw=1440&bih=740
#imgrc=NBgXJPzDqDV2yM: