Haemothorax in hereditary multiple exostosis

Abstract

Hereditary multiple exostosis (HME) or diaphysial aclasis is an autosomal dominant condition characterized by multiple exostoses which appear in different parts of the skeleton (Solomon, 1963). Lesions occur in infants and children and usually cease to enlarge at puberty. Complications are uncommon, and haemothorax has occasionally been described (Balatskii et al, 1973; Proper et al, 1980; Tejeira et al, 1989). We report a patient presenting with spontaneous haemothorax as a complication of costal exostoses. A 19-year-old boy known to have multiple exostoses was admitted with sudden pleuritic right-sided pain. There was no history of recent trauma. On examination he was apyrexial and blood pressure was normal. He had pain in the right side of his chest and shortness of breath and there was dullness to percussion and reducedbreath sounds at the right base.