There were swelling on the ribs and at the inner margin of scapulae. The bony swellings were noted since 2 years of age. One of her four brothers has similar swelling of the legs, ribs and scapulae. These changes are consistent with sessile and pedunculated multiple diaphyseal aclasia. Multiple exostoses is an autosomal domi-nant abormality commoner in males.
Cartilage capped osteomas occur at the metaphysis, particularly at the ends of the long bones.
These osteochondromes grow slowly with the child, cease to grow at maturity and may cause local problems by interfering with adjacent structures. A policy of selective excision should be adopted. Malignant changes may occur in adult life, particularly with exostoses affecting flat bones. Any growth in an exostoses after skeletal maturity should be considered suspicious of malignancy. The girl with her father and brother.