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

introductionOsteochondroma 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

methodsThis 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.

resultsOf 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).

conclusionsDiagnostic 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.