Background: Multiple exostosis (ME) is rarely reported in sub-Saharan Africa. This study aimed to describe the epidemiological, diagnostic and prognostic features of ME in Senegalese patients. Methods: A retrospective study was conducted, including all patient records from the Rheumatology Department at Aristide Le Dantec University Hospital between January 2016 and August 2025, for which an ME diagnosis had been made. Osteochondroma was diagnosed based on clinical and radiological evidence. Chondrosarcoma was confirmed by pathology. Results: Twenty cases were identified, including 18 men and 15 familial cases originating from three families. The prevalence among first-degree relatives was 10.18%, compared to 3.7% among second-degree relatives. The consanguinity rate was 55%. The median age at apparent disease onset was 9 years (range 1 to 18 years), and at diagnosis it was 28 years (range 9 to 58 years). Exostoses were located at the metaphyses of the limb bones in 90% of cases and at the axial skeleton in 65% of cases. The upper limbs were affected in 40% of cases and the lower limbs in 90%. The osteochondromas were painless in 12 cases (60%) and painful and growing in eight cases (40%). The number of osteochondromas recorded per patient ranged from 2 to 17. All patients had sessile exostoses. Two of them also had pedunculated exostoses. Bone deformities resulting in limb inequality were observed in seven cases. Vascular compression was recorded in two cases, one of which progressed to chondrosarcoma resulting in death due to pulmonary metastases. Conclusion: This is the largest series reported in Sub-Saharan Africa. The results reveal a high degree of familial aggregation and emphasize the importance of identifying cases within families for the early diagnosis and prevention of complications.
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