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Introduction <p>Osteochondroma or exostosis is the most common benign bone tumor and is typically diagnosed based on its characteristic radiographic features. While it is generally familiar to orthopaedic surgeons, the level of diagnostic familiarity among primary physicians remains unclear.</p> Materials and methods <p>This retrospective study reviewed 195 patients diagnosed with osteochondroma/exostosis who were referred to a tertiary orthopaedic oncology center. Inclusion criteria included radiological confirmation of osteochondroma/exostosis and the availability of referral documents. Diagnostic accuracy was assessed by classifying initial impressions as “osteochondroma/exostosis” or “other diagnoses.” Primary physicians were categorized by institutional affiliation (hospital or clinic) and specialty (orthopaedic or non-orthopaedic). A temporal analysis divided the study period into Period 1 (2005–2014) and Period 2 (2015–2024) to evaluate potential changes over time.</p> Results <p>Of the 195 cases, 118 (60.5%) were accurately described as osteochondroma or exostosis. Familiarity varied by anatomical location, with higher familiarity in long bones and lower familiarity in less typical sites such as toes, fingers, and ribs. Physicians affiliated with hospitals demonstrated significantly higher accuracy than those in clinics (<i>p</i> &lt; 0.05), and orthopaedic surgeons outperformed non-orthopaedic physicians (<i>p</i> &lt; 0.01). Temporal analysis showed no significant improvement over time: 50.0% in Period 1 and 62.4% in Period 2 (<i>p</i> = 0.22).</p> Conclusions <p>Diagnostic familiarity with osteochondroma/exostosis among primary physicians was moderate but varied by anatomical site and physician background. Improved musculoskeletal education, particularly regarding atypical presentations, may enhance diagnostic accuracy and referral quality.</p>

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Diagnostic familiarity with osteochondroma among primary physicians: a retrospective analysis of 195 referred cases

  • 期刊论文

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  • 发表日期：

    2026年3月6日

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  • Manabu Hoshi,
  • Masanari Aono,
  • Yoshitaka Ban

摘要

Introduction

Osteochondroma or exostosis is the most common benign bone tumor and is typically diagnosed based on its characteristic radiographic features. While it is generally familiar to orthopaedic surgeons, the level of diagnostic familiarity among primary physicians remains unclear.

Materials and methods

This retrospective study reviewed 195 patients diagnosed with osteochondroma/exostosis who were referred to a tertiary orthopaedic oncology center. Inclusion criteria included radiological confirmation of osteochondroma/exostosis and the availability of referral documents. Diagnostic accuracy was assessed by classifying initial impressions as “osteochondroma/exostosis” or “other diagnoses.” Primary physicians were categorized by institutional affiliation (hospital or clinic) and specialty (orthopaedic or non-orthopaedic). A temporal analysis divided the study period into Period 1 (2005–2014) and Period 2 (2015–2024) to evaluate potential changes over time.

Results

Of the 195 cases, 118 (60.5%) were accurately described as osteochondroma or exostosis. Familiarity varied by anatomical location, with higher familiarity in long bones and lower familiarity in less typical sites such as toes, fingers, and ribs. Physicians affiliated with hospitals demonstrated significantly higher accuracy than those in clinics (p < 0.05), and orthopaedic surgeons outperformed non-orthopaedic physicians (p < 0.01). Temporal analysis showed no significant improvement over time: 50.0% in Period 1 and 62.4% in Period 2 (p = 0.22).

Conclusions

Diagnostic familiarity with osteochondroma/exostosis among primary physicians was moderate but varied by anatomical site and physician background. Improved musculoskeletal education, particularly regarding atypical presentations, may enhance diagnostic accuracy and referral quality.