-
Cureus May 2024Osteoid osteoma (OO) is a common benign ossifying lesion that is most prevalent among youth. Usually, it attacks the diaphyseal or metaphyseal bones that are tubular....
Osteoid osteoma (OO) is a common benign ossifying lesion that is most prevalent among youth. Usually, it attacks the diaphyseal or metaphyseal bones that are tubular. The common hallmark of muscle pain is the reported occurrence of night pain that is nearly always present, yields satisfactory responses from nonsteroidal anti-inflammatory medications, and may be joined by complaints regarding physical activities. Also, it shows typical signs of study procedures like computed tomography (CT) and magnetic resonance imaging (MRI). A nidus, which is the primary marker in the diagnostic formation of shadowed images, is a crucial sign of an OO. This source is usually portrayed as an oval lytic lesion, measuring 1 cm flat and surrounded by a region of reactive ossification. It is laborious to diagnose OO since the condition is frequently confused with many other ones, and testing and therapy may be delayed and complicated as a result. There are still few studies on OO diagnosis and distinguishing of surrogate conditions. Unfortunately, either ablation or resection can be said to be the cure. Improved detection of OO shows the possibility for prompt diagnosis, fewer patient discomfort and side effects, less cost involved in unnecessary treatments, and a rightly diagnosed condition.
PubMed: 38947687
DOI: 10.7759/cureus.61332 -
Revista de La Facultad de Ciencias... Jun 2024Osteoid osteoma is a benign bone tumor that accounts for roughly 2-3% of primary bone tumors and up to 10-12% of benigns bone neoplasms. It is most commonly seen in...
INTRODUCTION
Osteoid osteoma is a benign bone tumor that accounts for roughly 2-3% of primary bone tumors and up to 10-12% of benigns bone neoplasms. It is most commonly seen in young adults, and shows male predominance. Over the last years, minimally invasive thermal ablation techniques such as radiofrequency ablation have gained popularity over classical surgery. In this study we evaluate results and complications of CT guided osteoid osteoma radiofrequency ablation.
MATERIALS AND METHODS
In this retrospective cohort study all patients that were diagnosed with osteoid osteoma and treated using radiofrequency ablation between January 2014 and December 2022 were included. Pain was assessed using Visual Analog Scale (VAS) pre and post procedure. Technical success was established as positioning of the radiofrequency electrode in the nidus. Primary clinical success was defined as absence of pain after one radiofrequency session. All patients that required a second radiofrequency ablation were included in the overall clinical success group.
RESULTS
During the studied period, 61 osteoid osteoma radiofrequency ablations were performed. Fiftyseven of them were included in this study, 32 were men and 25 female. Pre procedure median pain was 9 according to VAS score. Only 23 patients were treated as outpatient, the rest stayed in hospital for 24 hours. Median follow up time was 21,7 months (SD 8,3). Biopsy was performed in 52 patients. Technical success was accomplished in 57 patients (100%). Primary clinical success was 80,7% (46 patients). Those who continued with pain or had recurrence after a symptoms free period (11 patients), were treated with a second radiofrequency ablation, achieving an overall success rate of 94,7%. Only one patient suffered a minor complication (1,7%).
CONCLUSION
CT guided osteoid osteoma radiofrequency ablation is a safe, effective and low complication rate procedure, that can be performed on an outpatient basis. We believe it should be considered as a first line treatment option for osteoid osteoma.
Topics: Humans; Osteoma, Osteoid; Male; Female; Retrospective Studies; Bone Neoplasms; Adult; Radiofrequency Ablation; Treatment Outcome; Young Adult; Adolescent; Middle Aged; Tertiary Care Centers; Pain Measurement; Child
PubMed: 38941221
DOI: 10.31053/1853.0605.v81.n2.42451 -
Radiology Jun 2024A 15-year-old male patient presented with a 3-week history of inner left thigh pain provoked by activity and experienced occasionally at rest. The patient denied...
A 15-year-old male patient presented with a 3-week history of inner left thigh pain provoked by activity and experienced occasionally at rest. The patient denied nighttime pain, fever, or chills. Laboratory investigation revealed the following normal values: hemoglobin level of 15.6 g/dL (normal range, 13-16 g/dL), platelet count of 240 × 103/µL (normal range, 140-440 × 103/µL), and total leukocyte count of 7100 cells/µL (normal range, 4500-11 000 cells/µL). The percentage of neutrophils was considered low at 44% (normal range, 54%-62%), and the percentage of eosinophils was slightly high at 3.7% (normal range, 0%-3%). An anteroposterior radiograph of the left hip is shown. Physical therapy was initiated, with no improvement after 2 weeks of therapy. The patient was referred to an orthopedist for further evaluation. At physical examination, the patient endorsed marked left hip pain with hip flexion to 90°, limited internal and external rotation (5° and 15°, respectively), and antalgic gait favoring the left leg. Hip MRI and further serologic analysis were requested for further evaluation. Although the serologic testing was performed at an outside laboratory, the physician reported positive immunoglobulin-G Lyme titers, normal C-reactive protein level, and normal erythrocyte sedimentation rate. Pelvic CT was requested. The patient was prescribed a course of doxycycline (100 mg twice daily for 28 days), with reported resolution of symptoms 2 weeks after initiation of treatment. Three weeks later, the patient presented to our department with recurrent left hip pain, which was similar in severity compared with the initial presentation. A second MRI examination of the left hip was performed 4 months after the initial presentation.
Topics: Humans; Male; Adolescent; Osteoma, Osteoid; Magnetic Resonance Imaging; Diagnosis, Differential; Bone Neoplasms; Hip Joint
PubMed: 38916512
DOI: 10.1148/radiol.230629 -
Radiofrequency ablation of osteoid osteoma at the base of the coracoid process: Report of two cases.Clinical Case Reports Jul 2024If you encounter an unexplained case of bone marrow edema in a young patient, consider the possibility of osteoid osteoma (OO). Even in the presence of a nidus near...
If you encounter an unexplained case of bone marrow edema in a young patient, consider the possibility of osteoid osteoma (OO). Even in the presence of a nidus near vital structures, RFA can safely be used to treat OO.
PubMed: 38911920
DOI: 10.1002/ccr3.9098 -
Journal of Orthopaedic Case Reports Jun 2024Osteoblastoma is an uncommon benign bone tumor characterized by the formation of osteoid tissue, occurring more frequently in men than in women. It is often associated...
INTRODUCTION
Osteoblastoma is an uncommon benign bone tumor characterized by the formation of osteoid tissue, occurring more frequently in men than in women. It is often associated with osteoid osteoma and can be found at various locations in the skeleton, although it is rare in the sacrum. Typically, these lesions involve the posterior elements of the spine, including the pedicle and the lamina. We would like to present a case of sacral osteoblastoma, clinically presenting as lumbar radiculopathy, which was treated at our institute.
CASE REPORT
A 23-year-old male presented to us with left gluteal pain radiating to the left lower limb pain for 2 years. He had multiple consultations elsewhere and was being treated as a probable case of a lumbar disc lesion with left lower limb radiculopathy. X-rays appeared normal. Magnetic resonance imaging of the lumbar spine and pelvis revealed a T2 hyperintense lesion affecting the posterior elements of S3, compressing the nerve roots. Computed tomography (CT) was a better investigation modality for osteoblastoma. En bloc excision and curettage were performed, and the histopathological analysis confirmed the diagnosis of osteoblastoma. The patient had immediate relief of symptoms postoperatively with no complications. At 2-year follow-up, the patient had no evidence of recurrence on a follow-up CT scan.
CONCLUSION
Osteoblastomas predominantly occur in the spine, with rare instances in the sacrum. Treatment typically involves en bloc excision. Confusing clinical presentation may delay diagnosis, resulting in persistent morbidity.
PubMed: 38910997
DOI: 10.13107/jocr.2024.v14.i06.4520 -
Radiographics : a Review Publication of... Jul 2024Osteoid osteoma (OO) is the third most prevalent benign bone neoplasm in children. Although it predominantly affects the diaphysis of long bones, OO can assume an... (Review)
Review
Osteoid osteoma (OO) is the third most prevalent benign bone neoplasm in children. Although it predominantly affects the diaphysis of long bones, OO can assume an intra-articular location in the epiphysis or the intracapsular portions of bones. The most common location of intra-articular OO is the hip joint. The presentation of intra-articular OOs often poses a diagnostic enigma, both from clinical and radiologic perspectives. Initial symptoms are often vague and nonspecific, characterized by joint pain, stiffness, and limited range of motion, which frequently contributes to a delayed diagnosis. Radiographic findings range from normal to a subtle sclerotic focus, which may or may not have a lucent nidus. In contrast to their extra-articular counterparts, intra-articular lesions have distinct features at MRI, including synovitis, joint effusion, and bone marrow edema-like signal intensity. While CT remains the standard for identifying the nidus, even CT may be inadequate in visualizing it in some cases, necessitating the use of bone scintigraphy or fluorine 18-labeled sodium fluoride PET/CT for definitive diagnosis. Radiologists frequently play a pivotal role in suggesting this diagnosis. However, familiarity with the unique imaging attributes of intra-articular OO is key to this endeavor. Awareness of these distinctive imaging findings of intra-articular OO is crucial for avoiding diagnostic delay, ensuring timely intervention, and preventing unnecessary procedures or surgeries resulting from a misdiagnosis. The authors highlight and illustrate the different manifestations of intra-articular OO as compared with the more common extra-articular lesions with respect to clinical presentation and imaging findings. RSNA, 2024 Supplemental material is available for this article.
Topics: Humans; Osteoma, Osteoid; Bone Neoplasms; Diagnosis, Differential; Child; Magnetic Resonance Imaging; Hip Joint; Tomography, X-Ray Computed
PubMed: 38843097
DOI: 10.1148/rg.230208 -
International Journal of Surgery Case... Jun 2024Osteoid osteoma is a benign primary bone tumor with a predilection for the long bones and vertebrae, presenting a unique challenge when occurring in rare locations such...
INTRODUCTION AND IMPORTANCE
Osteoid osteoma is a benign primary bone tumor with a predilection for the long bones and vertebrae, presenting a unique challenge when occurring in rare locations such as the talus, accounting for 5 to 8 % of cases. Early imaging struggles to detect its nidus, leading to diagnostic delays, especially when atypical symptoms and previous trauma complicate clinical presentations. This case report illustrates the diagnostic challenges and emphasizes the importance of targeted computed tomography (CT) guided by scintigraphy in diagnosing osteoid osteoma of the talus.
CASE PRESENTATION
A 23-year-old male presented with chronic left ankle pain spanning three years, with a history of previous trauma. Initial evaluations including standard radiology and magnetic resonance imaging (MRI) suggested algodystrophy of the talus and tenosynovitis, but failed to identify the osteoma. Persistent pain led to further investigation with bone scintigraphy, revealing hyperfixation indicative of partial algodystrophy. Targeted CT scans focused on the scintigraphy-identified area ultimately revealed an osteoid osteoma's nidus, enabling successful surgical intervention and symptomatic relief.
DISCUSSION
The diagnosis of osteoid osteoma in the talus is frequently delayed due to its atypical presentation and rare occurrence. Traditional imaging techniques may overlook the tumor's nidus, underscoring the necessity for targeted diagnostic approaches. This case demonstrates the value of integrating scintigraphy with targeted CT to enhance early diagnosis and treatment planning, contrasting with the limited diagnostic yield of MRI and underscoring CT's superiority for nidus detection.
CONCLUSION
Osteoid osteoma of the talus poses significant diagnostic challenges. This case report highlights the utility of scintigraphy-guided targeted CT in identifying the nidus and facilitating prompt surgical management, advocating for a multidisciplinary approach to atypical ankle pain, especially in patients with a history of trauma.
PubMed: 38735215
DOI: 10.1016/j.ijscr.2024.109745 -
Journal of Clinical Orthopaedics and... May 2024Ulnar side wrist pain is a complex clinical situation because of the pathologies involving multiple closely located structures on the ulnar side of the wrist. Incidence...
Ulnar side wrist pain is a complex clinical situation because of the pathologies involving multiple closely located structures on the ulnar side of the wrist. Incidence of osseous lesions leading to ulnar side wrist pain is very rare. The effectiveness of commonly employed Magnetic resonance imaging, for diagnosing the pathology in the ulnar side of the wrist might be limited in diagnosing such osseous lesions and can lead to missed diagnosis. We herein present such a rare case of Osteoid osteoma of the hook of hamate presenting as ulnar side wrist pain. The condition, presented a "diagnostic challenge", where it required Computed Tomography to diagnose and guide for appropriate management.
PubMed: 38708093
DOI: 10.1016/j.jcot.2024.102418 -
Journal of Personalized Medicine Apr 2024The aim of this study was to evaluate treatment of osteoid osteomas using bipolar radiofrequency ablation (RFA) and patients' quality of life before and after therapy....
The aim of this study was to evaluate treatment of osteoid osteomas using bipolar radiofrequency ablation (RFA) and patients' quality of life before and after therapy. We retrospectively evaluated patients who underwent bipolar RFA of osteoid osteomas between 2001 and 2016. We assessed patients' symptoms before and after treatment (four weeks after treatment and long-term) using a questionnaire including severity and quality of pain on a 10-point scale (1 = no pain, 10 = severe pain), motion restrictions, pain-related sleep disorders, and necessary pain medication. In addition, we evaluated technical success, complications, hospitalization length, and patients' satisfaction with treatment. This study included 62 patients (43 [69.4%] males, 26.2 ± 13.2 years). Average nidus size was 5.7 ± 2.6 mm. The rate of technical success was 100%. All RFAs were performed without any complications. One patient showed a recurrence, resulting in a recurrence rate of 1.6%, which was successfully treated by another session of RFA. Average hospitalization length was 1.5 ± 0.5 days. A total of 36 patients (58.1%) participated in the questionnaire, reporting an average pain severity of 8.2 ± 1.6 before RFA compared to 3.4 ± 3.0 four weeks after and an average of 2.1 ± 2.3, 6.6 years after therapy, (both < 0.001). After therapy, 31 (86.1%) patients had no pain. The majority of patients ( = 34, 94.4%) had reduced or absent motion restriction after therapy ( < 0.001). Patient satisfaction rate was 91.7%. In conclusion, bipolar RFA is a safe and effective treatment modality for osteoid osteomas and improves quality of life by reducing pain severity and motion restrictions.
PubMed: 38673028
DOI: 10.3390/jpm14040401 -
Skeletal Radiology Apr 2024Osteoid osteoma (OO) is a common, benign bone tumor. However, there are no case reports of OO associated with osteogenesis imperfecta (OI), or pathological fractures in...
Osteoid osteoma (OO) is a common, benign bone tumor. However, there are no case reports of OO associated with osteogenesis imperfecta (OI), or pathological fractures in OO. A 3-year-old girl with OI sustained a complete right tibial diaphyseal fracture. Bony fusion was completed after 4 months of conservative therapy; nevertheless, 18 months later spontaneous pain appeared at the fracture site, without any cause. Plain radiographs showed a newly apparent, rounded area of translucency 1 cm in diameter, just overlapping the previous fracture. Images obtained using three-dimensional time-resolved contrast-enhanced magnetic resonance angiography showed strong central enhancement in the early phase, with an apparent nidus, suggesting the diagnosis of OO. Nineteen months after the first fracture, while skipping, the patient refractured her tibial diaphysis at the site of the previous fracture. This is a very rare case of OO, apparently co-existing with OI and leading to a bony fracture. In our case, the combination of bone fragility in OI and a recent fracture at the site of the OO may have caused the re-fracture.
PubMed: 38647687
DOI: 10.1007/s00256-024-04672-w