Hereditary multiple exostoses.

Hereditary multiple exostoses (HME) is a skeletal disorder which primarily affects enchondral bone during growth. It is characterised by multiple exostoses, usually arising in the juxtaepiphyseal region of the long bones. Exostoses that affect "almost every bone in the body" were first mentioned by John Hunter in his Lectures on the principles of surgery in 1786.1 The first family affected by HME was described by Boyer2 in 1814. Virchow3 named the disorder multiple exostoses in 1876, and Keith4 suggested the name diaphyseal aclasis; this term is still popular in the UK. Several other names have been used in the past and are still used today, including 'osteogenic disease', 'chondral osteogenic dysplasia', 'chondral osteoma', 'dyschondroplasia', 'deforming chondrodysplasia', 'multiple hereditary osteochondromata', 'multiple cartilaginous exostoses', or simply 'exostosis' or 'exostotic dysplasia'. Papers that were especially important in further delineatinj the disorder were those of Jaffe,5 Solomon, and Shapiro et al.9 HME may be found not only in man, but also in horse, cattle, dog, cat, lion, and lizard.'0 11 A large exostosis was even found on the scapula of a dinosaur.'0