Pneumothorax as the first presentation of multiple exostosis.

This article underscores the critical importance of thorough physical examinations and the need to investigate secondary causes in cases of refractory pneumothorax. The identification of hereditary multiple exostoses (HME) as the underlying condition highlights the necessity of considering rare etiologies, particularly in atypical presentations. While exostoses typically affect long bones, they can also involve the ribs and scapulae, leading to complications such as pneumothorax. In pediatric patients, where multiple symptoms may arise from a single condition, a multidisciplinary approach is essential for accurate diagnosis and effective management.