Pt with possible 1 cm bone spur on fore head 3 years after mvc. slow growth. any considerations? imaging first? just chisel it off? thank you

Imaging first: To exclude mucocoele. If negative, i I have used hairline incision with lighted retractors and ostectome to remove.

CT imaging first: Although the clinical suspicion can be very strong, CT imaging will keep you out of trouble in case it's something else.

See below: I would definitely image it first to ensure it's not something more malignant than a cosmetic defect. If just cosmesis, then could probably surgically remove it but would refer this to a head/neck surgeon or facial plastic surgeon.

Ct scan: Of course you would want to characterize the "bone spur" further before you chisel it off as you out it. This is not a common place for an osteophyte. At a minimum a ct scan of the head/skull would be beneficial to characterize the area further.

Watch bone spurgrowt: Bony spur may be result of post trauma due to MVC and slow growth may not cause any worry . IImaging may help to exclude if any abnormal finding specially malignant changes or any cyst formation ,If imaging is normal and bone spur dose not bother the patient ,explain and convince that bone spur is slow growing . Chislelling may not needed unless any changes come up.