ARM EXOSTOSIS
(Blocker's Nodule)

Description
Blocker’s exostosis is caused by an overgrowth of bone along the outside of the forearm or upper arm that is caused by repeated injury, usually direct blows. This is a benign bony reaction to repeated injury. Risk increases with repeated injury and contact sports like football and rugby.

Symptoms
May have no symptoms.

If symptomatic, may have pain, tenderness, and sensitivity at the site of the exostosis that is sensitive to pressure. May have swelling or bruising in the area.
Visible change in the contour of the arm, depending on the size of the exostosis, ranging from a small lump or bump to a large spur.

Occasionally, a movable piece of bone may be felt in the arm when a spur breaks off.

Complications
Prolonged healing time if activity is resumed too soon
Pressure on nearby nerves, blood vessels, muscles, ligaments, tendons, or other soft
tissue
Formation of a bursa over the exostosis, which may get inflamed and cause pain

Treatment
If there are no symptoms, no treatment is necessary except padding of the area during contact sports. Initial treatment may consist of medication,  ice, and modification of exacerbating activities. Cold treatments are usually helpful in resolving the symptoms. Cortisone injections may be helpful in chronic cases. Rarely, surgery to remove the exostosis if symptoms persist despite at least 6 months of conservative treatment.
 

Cold should be applied for 20 minutes 4 times daily. Occasionally a referral to a physical therapist or athletic trainer is indicated for rehabilitation management. Crutches may be recommended for the first 24 to 72 hours if the injury is severe.