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Journal of Orthopaedic Case Reports Aug 2023The elbow pain and restricted movement is a nagging problem and elbow arthropathies need to be excluded. On rare instances, uncommon etiology like a benign lesion is the...
INTRODUCTION
The elbow pain and restricted movement is a nagging problem and elbow arthropathies need to be excluded. On rare instances, uncommon etiology like a benign lesion is the culprit and the diagnosis would require judicious clinicoradiological correlation. Osteoid osteoma in the intra- or juxta-articular region is reported in the literature as rare, sporadic report.
CASE REPORT
A 23-year-old, Indian male patient presented with a provisional diagnosis of early elbow arthropathy on account of unexplained pain and restricted elbow movement without a history of trauma. He was subjected to appropriate investigations revealing synovial hypertrophy, effusion, and bone edema suggestive of early arthropathy. Additional imaging led to an uncommon definitive diagnosis. An intra-articular osteoid osteoma was found over the medial aspect of the coronoid fossa with a thin rim of cortical rim projecting anteriorly. The lesion was diagnosed and delineated on computerized tomography and an open excision of the lesion and synovectomy was done for histopathological evaluation. Histology confirmed the presence of an osteoid osteoma at an uncommon location.
CONCLUSION
The careful appreciation of radiological images is critical to not miss significant etiology that may mimic non-specific elbow pain. High index of suspicion coupled with appropriate diagnostic imaging results in early diagnosis and appropriate management. Osteoid osteoma should be a differential diagnosis in cases with pain and restricted elbow movement and excision of which results in recovery of painless range of motion.
PubMed: 37654760
DOI: 10.13107/jocr.2023.v13.i08.3842 -
Cureus Jul 2023Introduction Osteoid osteomas are the most frequent true benign bone tumor in the adolescent age group and the third most prevalent benign bone tumor overall. This study...
Introduction Osteoid osteomas are the most frequent true benign bone tumor in the adolescent age group and the third most prevalent benign bone tumor overall. This study was designed to assess the effectiveness of the procedure and correlate it with the analgesia offered because of the significant burden of this illness and new literature supporting the successful outcomes of image-guided percutaneous radiofrequency ablation (RFA) in osteoid osteoma. Methodology This hospital-based interventional trial was carried out in a tertiary care referral center. Forty-two patients with osteoid osteoma, ranging in age from 9 to 30, were included in the study. The patients received RFA guided by computed tomography (CT), and they were postoperatively monitored at one, two, and four weeks and three, six months, and 12 months. A numerical pain scale (NPS) was used to evaluate the patient's pain both before and after the procedure. The preoperative and postoperative results were contrasted. Results A total of 42 participants were enrolled in the study. Eight (19.05%) women and 34 (80.95%) men made up the group. Complete pain alleviation (NPS=0) was attained in 42.8% and 96.4% of the study group in the first and second weeks post-procedure. Almost all patients began protected weight-bearing at one week, according to their level of pain tolerance. Osteoid osteoma of the talus was a remnant lesion in one patient that required further treatment after two weeks. During the duration of the follow-up, no problems were recorded. Conclusion Percutaneous CT-guided RFA of osteoid osteoma is a safe, minimally invasive procedure and greatly reduces the duration of hospitalization. It has excellent functional outcomes and no known complications.
PubMed: 37649955
DOI: 10.7759/cureus.42675 -
Cureus Jul 2023Introduction Osteoid osteoma is a benign condition of the bone, usually affecting young males. This retrospective study explores the demographics of osteoid osteomas in...
Introduction Osteoid osteoma is a benign condition of the bone, usually affecting young males. This retrospective study explores the demographics of osteoid osteomas in the Northern Irish population. It also aims to audit the practice of CT-guided radiofrequency ablation of osteoid osteomas at a major orthopaedic centre in Belfast, Northern Ireland, and to investigate the possible causes of treatment failure. Methods Forty-seven osteoid osteoma patients, diagnosed based on clinico-radiologic features and treated with CT-guided radiofrequency ablation, were found eligible for inclusion and analysis. We collected data from electronic health records (March 2011 to May 2022) and reviewed the radiological images and associated reports. Information about demographics, clinical indices, operative technique, clinical outcomes, biopsy results, and follow-up were also gathered. Data were then analysed using IBM SPSS Statistics for Mac, version 28.0.1.1 (14) (IBM Corp., Armonk, NY). Results The average age of patients was 19.3 years, with a male-to-female predilection of 2.1:1. The proximal and mid-tibial shafts were the most frequently involved sites. On average, patients had symptoms for 15.6 months, while the mean treatment delay period was 6.9 months. Primary clinical success was observed in 37 patients (78.7%), while ten patients had a clinical failure. Two out of the 10 patients with treatment failure underwent subsequent successful ablations, raising the secondary clinical success rate to (83.0%). Chi-Square association tests found no correlation between primary treatment outcomes and other qualitative variables (gender, bone type, lesion location, and Kayser classification). Moreover, binary logistic regression tests found no predictability of age and treatment delay on treatment outcomes. The overall observed complication rate was 4%, with only one significant side effect reported (third-degree skin burn). Conclusion We concluded that the demographics of osteoid osteomas in the Northern Irish population are comparable to what is previously established in the literature. Furthermore, we reasoned that CT-guided radiofrequency ablation is an efficient, safe, and effective minimally invasive technique in the management of osteoid osteomas.
PubMed: 37593307
DOI: 10.7759/cureus.42034 -
Medicine Aug 2023Osteoid osteoma is a relatively common benign bone-forming lesion that often occurs in young adults with a predilection for the lower limbs and spine. It is...
RATIONALE
Osteoid osteoma is a relatively common benign bone-forming lesion that often occurs in young adults with a predilection for the lower limbs and spine. It is characterized by the formation of osteoid tissue, a precursor to bone, and can cause pain and restricted mobility in affected areas. Osteoid osteoma of the hand and fingers is rare, thus representing a diagnostic challenge. A written informed consent was provided from the patient's father for the publication and sharing all images and clinical data concerning the patient.
PATIENT CONCERNS
We are reporting a case of an 11-year-old girl who presented with persistent pain and swelling in her left index finger, as well as limited mobility, over the course of 1 year. Nonsteroidal anti-inflammatory drugs eased the pain, but it resurfaced once the medication was discontinued.
DIAGNOSES
A series of investigations, showed a lytic lesion at the second proximal phalangeal neck, with features indicative of osteoid osteoma.
INTERVENTIONS
Excision with bone grafting was performed as definitive therapy with pathological confirmation of the osteoid osteoma diagnosis. Nevertheless, the patient returned 2 years later with a recurrence of her previous symptoms, and further tests suggested a recurrence of osteoid osteoma. To address the recurrence, a modified open thermoablation technique was used. Thermoablation is a minimally invasive procedure that uses heat to destroy the tumor cells, and it has been shown to be effective in treating osteoid osteoma. The modified open approach involves making a small incision to access the tumor and delivering heat directly through a previously CT-guided inserted Kirschner wire to the affected area.
OUTCOMES
The patient reported no pain at 1 month and 1 year after the surgery, with no radiological signs of recurrence, indicating complete excision of the lesion.
LESSONS
Overall, this case highlights the challenges of diagnosing and treating osteoid osteoma in the hands and fingers. Further research is needed to better understand the underlying causes, potential risk factors, and optimal treatment for osteoid osteoma recurrence.
Topics: Humans; Female; Young Adult; Child; Osteoma, Osteoid; Bone Neoplasms; Pain; Radiography; Fingers
PubMed: 37543830
DOI: 10.1097/MD.0000000000034490 -
European Journal of Radiology Sep 2023Magnetic resonance-guided focused ultrasound (MRgFUS) is a novel noninvasive interventional technique for osteoid osteoma (OO). The purpose of this study was to evaluate... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Magnetic resonance-guided focused ultrasound (MRgFUS) is a novel noninvasive interventional technique for osteoid osteoma (OO). The purpose of this study was to evaluate the efficacy and safety of MRgFUS in the treatment of OO through a systematic review and meta-analysis of pain scores and post-treatment adverse events before and after MRgFUS treatment.
MATERIALS AND METHODS
A comprehensive literature search of PubMed, Embase, Web of science, and Cochrane Library databases was conducted to screen the study literature based on inclusion and exclusion criteria to extract and analyze pre- and post-treatment pain score data, success rates (complete pain relief with no recurrence until the last follow-up), recurrence rates, secondary intervention rates, and complications to evaluate the efficacy and/or safety of MRgFUS for OO.
RESULTS
A total of 113 studies published between 2012 and 2022were collected, resulting in a total sample size of 353 patients. The majority of the studies were prospective and had a follow-up period of 4 weeks or more, and overall, the quality of evidence ranged from low to high. Pain scores at 1 week and 1 month after the merger were 0.62 (9.5% CI:0.28-0.96) and 0.37 (9.5% CI:0.07-0.68), respectively. The success rate of the combination was 92.8% (95% CI: 89.8%-95.7%), the incidence of minor complications (thermal injury at the ablation site) was 0.85%, and no major complications were recorded in any of the included literature.
CONCLUSION
MRgFUS is an effective procedure that is able to treat pain for patients with OO with satisfying efficacy and safety.
PROSPERO
No.CRD42023415573.
Topics: Humans; Osteoma, Osteoid; Prospective Studies; Pain; Bone Neoplasms; Magnetic Resonance Spectroscopy; Treatment Outcome
PubMed: 37523874
DOI: 10.1016/j.ejrad.2023.111006 -
Frontiers in Oncology 2023Nasal osteoblastoma (OB) is a rare and locally aggressive osteogenic tumor that has rarely been reported, and there is a lack of effective evidence data for its...
Nasal osteoblastoma (OB) is a rare and locally aggressive osteogenic tumor that has rarely been reported, and there is a lack of effective evidence data for its diagnosis and treatment. In this study, we report a 31-year-old female patient who presented with nasal congestion and associated progressive painless swelling of the left maxillofacial region. A preoperative computed tomography (CT) examination of the paranasal sinuses was performed, and based on the imaging presentation, the surgeon was unable to differentiate between OB, osteoid osteoma (OO), fibrous dysplasia of bone (FDB) and osteoblastic fibroma (OF). After excluding contraindications to surgery, the patient underwent nasal endoscopic excision of the left nasal mass, which was found to be gravel-like and difficult to remove cleanly during the operation. The mass was brittle and bled easily, resulting in inadequate exposure of the operative field, prolonged operation time, and substantial intraoperative blood loss. This indicates that definite preoperative diagnosis (biopsy of deeper parts of the mass is recommended) and appropriate preoperative preparations (e.g., preoperative angiography and embolization, adequate blood preparation) are very important. The intraoperative frozen and postoperative pathological results clearly identified the tumor as OB. No local recurrence of the tumor was observed at the 11-month postoperative follow-up.
PubMed: 37519816
DOI: 10.3389/fonc.2023.1168777