Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Job Classification

In most duration tables, five job classifications are displayed. These job classifications are based on the amount of physical effort required to perform the work. The classifications correspond to the Strength Factor classifications described in the United States Department of Labor's Dictionary of Occupational Titles. The following definitions are quoted directly from that publication.

Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Osteoma


Related Terms

  • Benign Bone Tumor
  • Exostosis

Differential Diagnosis

Specialists

  • Dentist
  • Oncologist
  • Orthopedic (Orthopaedic) Surgeon
  • Otolaryngologist
  • Radiologist

Comorbid Conditions

Factors Influencing Duration

Factors that may influence length of disability include age, the site of the osteoma, and the extent of the surgery required to remove it.

Medical Codes

ICD-9-CM:
213 - Benign Neoplasm of Bone and Articular Cartilage
213.0 - Neoplasm, Bones of Skull and Face, Benign
213.1 - Neoplasm, Lower Jaw Bone, Benign
213.2 - Neoplasm, Vertebral Column, Excluding Sacrum and Coccyx, Benign
213.3 - Neoplasm, Ribs, Sternum, and Clavicle, Benign
213.4 - Neoplasm, Scapula and Long Bones of Upper Limb, Benign
213.5 - Neoplasm, Short Bones of Upper Limb, Benign
213.6 - Neoplasm, Pelvic Bones, Sacrum, and Coccyx, Benign
213.7 - Neoplasm, Long Bones of Lower Limb, Benign
213.8 - Neoplasm, Short Bones of Lower Limb, Benign
213.9 - Neoplasm, Bone and Articular Cartilage, Benign, Site Unspecified
M9180/0 - Osteoma

Overview

An osteoma is a small, noncancerous (benign), slow-growing tumor that is composed of abnormally dense but otherwise normal bone.

Osteomas may form in response to trauma, infection, an invading tumor such as a meningioma, or a soft tissue lesion adjacent to the bone such as a hemangioma or lipoma.

Osteomas are sometimes found in association with other diseases, such as polyps, fibromatous lesions of the connective tissue, or epidermal cysts (Gardner's syndrome). Although osteomas typically occur singly, multiple osteomas may occur in Gardner's syndrome, a disease characterized by multiple internal polyps and other nonmalignant tumors. The most common sites for tumor development are the skull and facial bones, and osteomas are the most frequent benign tumors of the paranasal sinuses. Osteomas of the long bones and spine are uncommon in adults.

Incidence and Prevalence: The overall incidence of osteoma is low, affecting 0.01 to 0.04% of the population; osteomas comprise 12.1% of benign bone tumors and 2.9% of all bone tumors (Khan).

Source: Medical Disability Advisor



Causation and Known Risk Factors

Osteomas occur in all age groups but most commonly develop in the 30- to 60-year age group. Overall, osteomas are 3 times more common in women than men, but the type of osteoma known as osteoid osteoma usually occurs in children and young adults and is 2 times more common in males than females. Black individuals seldom get osteomas.

Source: Medical Disability Advisor



Diagnosis

History: The individual may complain of pain, often in the area of a protruding bone mass. In the long bone, the individual may have noticed a mass or lesion that enlarged gradually. Individuals with osteoma of the sinus region may complain of headache, facial swelling (edema), runny nose (rhinorrhea), and sinusitis. Osteomas are characterized by pain that worsens at night and is relieved by small doses of aspirin. In 29% of individuals, the pain may be severe enough to waken the individual. If the tumor involves the spine, secondary muscle spasm may occur and cause abnormal alignment, usually scoliosis. In fact, osteoma is the most common cause of painful scoliosis. If the hip is involved, pain may radiate into the leg. Nerve pressure and deformity from the osteoma are the most frequent causes of pain. Some individuals have no symptoms at all.

Physical exam: The exam may reveal the area containing an osteoma as a visible mass that is noticeable to the touch (palpable).

Tests: To confirm the diagnosis, x-rays of the area are taken. Using the x-ray, a physician can exclude other tumors because the mass is very dense and attached to the bone cortex. It will be clear that the underlying bone is not involved and that there is no mineralization of surrounding soft tissues. A CT scan may be needed to delineate the margins of the tumor. Magnetic resonance imaging (MRI) can be useful in evaluating osteomas, but CT scanning is generally superior. A bone scan (scintigraph) can also be useful in evaluating and localizing the tumor.

Source: Medical Disability Advisor



Treatment

Osteomas are treated only if they cause symptoms. Nonprescription nonsteroidal anti-inflammatory drugs or aspirin will often be sufficient to control pain. If the individual is symptomatic or the diagnosis is in doubt, surgery may be performed to remove the mass (excision). A new surgical technique (radiofrequency ablation; RFA) is now being performed on some individuals who have osteoid osteoma; this procedure is less invasive than traditional surgical excision.

Source: Medical Disability Advisor



Prognosis

Some individuals experience a spontaneous regression of their osteoma over an extended period of time (3 to 7 years). Most osteomas, however, do not regress, but because growth is slow, the individual may experience a very good outcome for several years using pain medication alone. Prognosis is also very good with surgical removal (excision) of the mass, and most individuals recover completely. Radiofrequency ablation also has very good outcomes, but some individuals experience a recurrence, and about 10% will require a second procedure.

Source: Medical Disability Advisor



Complications

Complications associated with the development of an osteoma often depend on the location of the tumor and may include the obstruction of one or more sinus cavities and the inhibition of normal dental formation or tongue movement.

Source: Medical Disability Advisor



Ability to Work (Return to Work Considerations)

Work leave for surgery and recuperation may be necessary. Individuals with osteoma in the leg are advised to avoid vigorous physical activity, such as running or jumping, for 3 months.

Source: Medical Disability Advisor



Failure to Recover

If an individual fails to recover within the expected maximum duration period, the reader may wish to consider the following questions to better understand the specifics of an individual's medical case.

Regarding diagnosis:

  • Does individual complain of pain or soreness, either related to a swelling on a bone or to headaches?
  • Has diagnosis of osteoma been confirmed through x-rays?
  • Are additional imaging techniques needed to confirm diagnosis?

Regarding treatment:

  • If osteomas are causing symptoms, or if medication is not effective in controlling pain, is individual now a candidate for surgical intervention?
  • Would individual be a candidate for radiofrequency ablation?
  • Was surgery required?
  • Did surgery confirm the diagnosis of osteomas?

Regarding prognosis:

  • Is the osteoma located in an area where symptoms impair function?
  • Is this an initial osteoma or a recurrence of a previous one? Is surgical excision now being considered?
  • How effective is medication in controlling pain?
  • Did individual experience any complications associated with the generally successful removal of the mass?
  • Is there a situation that may affect recovery?

Source: Medical Disability Advisor



References

Cited

Khan, Ali Nawaz, et al. "Osteoid Osteoma." eMedicine. Eds. Leon Lenchik, et al. 15 Aug. 2002. Medscape. 2 Nov. 2004 <http://emedicine.com/radio/topic498.htm>.

Source: Medical Disability Advisor






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