Multiple Hereditary Exostoses Specialist

David S. Feldman, MD

Orthopedic Specialist located in West Palm Beach, FL

Multiple hereditary exostoses (MHE) is a rare genetic disorder, affecting 1 out of 50,000, characterized by multiple bony growths found on the surface of bones that cause deformities and pain. World-renowned board-certified orthopedic surgeon David S. Feldman, MD, in West Palm Beach, Florida, is an MHE specialist and offers comprehensive and innovative care focused on alleviating symptoms and improving quality of life. To learn why patients travel from all over the world to seek his care, schedule an appointment with Dr. Feldman and his team, call the office or click the online booking button.

Multiple Hereditary Exostoses Q & A

What is multiple hereditary exostoses (MHE)?

MHE is a genetic autosomal dominant disorder that most commonly affects EXT1 and EXT2 genes. The benign condition is characterized by multiple osteochondromas (bony growths) found on the surface of the bones, often at the site of tendon insertion.

This genetic condition often causes progressive skeletal deformities of the extremities that lead to shortening of one or both sides, resulting in limb length discrepancy and short stature. The two bone segments of the lower leg or forearm are at greatest risk of problems because the osteochondromas from one or both bones may impinge on or deform the other bone. The bony growths may also cause the bone to grow at a faster or slower rate.

Osteochondromas may also affect joint mobility by impinging on the opposite side of the joint or lead to joint dislocation. The bony growths also entrap and compress nerves, including the spinal cord and nerve roots. Tethering of tendons or muscles lead to locking or restriction of joint range of motion, as well as pain.

How is MHE diagnosed?

Dr. Feldman is an MHE specialist and conducts comprehensive clinical exams to diagnose the rare genetic condition. Your exam may include a review of symptoms and medical history, X-rays, and genetic testing. However, with current genetic technology, 15% of patients with MHE have “normal” genetic results. 

How is MHE treated?

Dr. Feldman specializes in the treatment of MHE and takes a holistic and integrated approach to treating the rare disorder. He develops individualized treatment plans aimed at addressing current MHE complications and preventing new issues from occurring.

Your treatment plan may include:

  • Straightening a crooked limb
  • Removing all osteochondromas
  • Taking steps to prevent joint dislocation
  • Treating nerve pain caused by osteochondroma entrapment

Dr. Feldman offers heparin sulphate (HS) as a possible medical treatment for MHE, which affects many signaling pathways in bone and cartilage. He’s also involved in a drug trial with palovarotene (PVO), which may help decrease tumor growth. 

Dr. Feldman is one of the leading specialists in the management of MHE and offers innovative treatments that no other orthopedic surgeon offers. To schedule a consultation, contact his office by phone or online today.