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Care Team for Patients with MHE

People with MHE may benefit from a multidisciplinary care team. Members of the care team who are involved in providing care may include the following roles.

Orthopedic Surgeon

- Plays a core role in the care and treatment of MHE.

- Manages skeletal deformities and physical symptoms caused by osteochondromas.

- Evaluates and performs surgical interventions, such as excision of symptomatic osteochondromas or correction deformities.

- Monitors for complications like nerve impingement, vascular compression.

Genetic Counselor

- Provides genetic counseling for the patient and their family.

- Offers genetic testing for confirmation of the condition and identifies the specific gene mutation (EXT1, EXT2).

- Facilitates conversations about family planning and the risk of passing MHE to future children.

Primary Care Physician (PCP)

- Refers to specialists and oversees routine health management, including monitoring growth and development in pediatric patients.

Radiologist

- Interprets imaging studies (X-rays, MRI, CT scans) ordered by the Orthopedic Surgeon to evaluate the location and size of osteochondromas.

- Plays a role in detecting complications like malignant transformation (which may require advanced imaging studies).

Physical Therapist (PT)

- Helps in managing pain and improving mobility and strength.

- Designs programs tailored to to help with range of motion, flexibility, and muscle strengthening.

- Assists in the rehabilitation process post-surgery.

Occupational Therapist (OT)

- Provides support for functional challenges, especially if MHE affects daily activities, such as dressing, personal care, and working.

- Helps with adaptive devices or techniques.

Pain Management (if needed)

- Assists in managing chronic pain, which can occur due to osteochondromas pressing on soft tissues and nerves, or causing skeletal deformities.

- Uses a combination of medications, physical therapies, and possibly interventional procedures to alleviate pain.

Psychologist or Psychiatrist (if needed)

- Provides mental health support, especially for patients who may experience emotional or psychological distress related to chronic pain, body image issues, or the challenges of living with a genetic condition.

- Offers counseling and coping strategies for anxiety, depression, or social difficulties.

Care Manager or Social Worker (if needed)

- Provides support for navigating the healthcare system and accessing resources like financial aid, durable medical equipment (ex: wheelchairs), educational accommodations, or disability services.

- Helps coordinate care across multiple specialists and addresses any social or practical challenges the patient may face.

Orthotist (if needed)

- May design custom orthotics or braces to help correct skeletal deformities, assist with mobility, or provide support for weakened joints.

Oncologist (if needed)

- In rare cases where there is concern for malignant transformation of an osteochondroma into chondrosarcoma, an oncologist will be involved for cancer diagnosis and management.

- Works closely with orthopedic surgeons and radiologists for monitoring and treatment if malignancy is detected.