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Skeletal Radiology Feb 2024Magnetic resonance-guided focused ultrasound (MRgFUS) is a noninvasive, incisionless, radiation-free technology used to ablate tissue deep within the body. This... (Review)
Review
Magnetic resonance-guided focused ultrasound (MRgFUS) is a noninvasive, incisionless, radiation-free technology used to ablate tissue deep within the body. This technique has gained increased popularity following FDA approval for treatment of pain related to bone metastases and limited approval for treatment of osteoid osteoma. MRgFUS delivers superior visualization of soft tissue targets in unlimited imaging planes and precision in targeting and delivery of thermal dose which is all provided during real-time monitoring using MR thermometry. This paper provides an overview of the common musculoskeletal applications of MRgFUS along with updates on clinical outcomes and discussion of future applications.
PubMed: 38363419
DOI: 10.1007/s00256-024-04620-8 -
Journal of Neurosurgery. Case Lessons Feb 2024Osteoid osteoma is a common benign bone tumor frequently seen in the frontoethmoid region. However, involvement of the skull base is rare, with few cases previously...
BACKGROUND
Osteoid osteoma is a common benign bone tumor frequently seen in the frontoethmoid region. However, involvement of the skull base is rare, with few cases previously reported.
OBSERVATIONS
The authors report two cases of spontaneous, symptomatic frontoethmoidal osteoma: one presented with neurological deficit secondary to tension pneumocephalus and the other with cerebrospinal fluid leakage. The first case was managed with a transfrontal sinus craniotomy and pneumocephalus decompression with osteoma resection and skull base reconstruction. The second case was managed with a uninaral endoscopic endonasal approach to the anterior skull base with osteoma resection and reconstruction.
LESSONS
Given the paucity of cases with associated tension pneumocephalus described in the literature, it was relevant to describe the authors' experience with surgical decision-making and the expected outcomes among patients with this pathology when using minimally invasive techniques.
PubMed: 38315987
DOI: 10.3171/CASE23699 -
Medicine Feb 2024Osteoid osteoma (OO) is a benign lesion characterized by an increased fibrous component in the bone marrow, presence of bone-like structures within the medullary cavity,... (Review)
Review
BACKGROUND
Osteoid osteoma (OO) is a benign lesion characterized by an increased fibrous component in the bone marrow, presence of bone-like structures within the medullary cavity, and a surrounding sclerotic bone rim. Reports on OO located in the posterior proximal tibia are rare.
CASE SUMMARY
Herein, we report the case of an 18-year-old male, admitted for the evaluation of right knee pain. The right knee pain had started 6 months prior without any apparent cause, which was notably severe at night, affecting sleep, and was exacerbated while climbing stairs or bearing weight. The patient also experienced pain on flexion. Three-dimensional computed tomography and magnetic resonance imaging revealed a nodular lesion beneath the cortical bone of the posterior medial plateau of the right tibia and an abnormal signal focus on the posterior lateral aspect of the right tibial plateau associated with extensive bone marrow edema. A small amount of fluid was present in the right knee joint capsule. The patient subsequently underwent arthroscopic excision of the OO. Postoperatively, there was significant relief of pain, and the knee range of motion returned to normal.
CONCLUSION
Although OO in the posterior proximal tibia is a rare occurrence, it can be effectively excised through minimally invasive arthroscopic visualization.
Topics: Male; Humans; Adolescent; Tibia; Osteoma, Osteoid; Bone Neoplasms; Pain; Knee
PubMed: 38306554
DOI: 10.1097/MD.0000000000037076 -
Journal of Surgical Case Reports Jan 2024In the elbow joint, occurrences of intra-articular osteoid osteoma are uncommon. We detail the case of a 21-year-old male who experienced pain, inflammation, and a...
In the elbow joint, occurrences of intra-articular osteoid osteoma are uncommon. We detail the case of a 21-year-old male who experienced pain, inflammation, and a restricted ability to move his elbow. For a few months, the diagnoses was missed and the patient was treated for idiopathic synovitis. After a contrast MRI, the tumor was revealed. During an arthroscopic examination of the elbow, a distinct red lesion was observed after the removal of the pale reactive bone in the olecranon cavity. This was subsequently removed in its entirety with the aid of a specialized bone tool. Histopathology confirmed the diagnosis of osteoid osteoma. Remarkably, the individual reported alleviation from the symptoms just a day following the operation and regained full range of motion 5 weeks after the surgery. This case underscores the efficacy of arthroscopy in addressing intra-articular osteoid osteoma, with a focus on accurately pinpointing the lesion.
PubMed: 38239375
DOI: 10.1093/jscr/rjad720 -
Zhongguo Xiu Fu Chong Jian Wai Ke Za... Jan 2024To compare the accuracy and effectiveness of orthopaedic robot-assisted minimally invasive surgery versus open surgery for limb osteoid osteoma.
OBJECTIVE
To compare the accuracy and effectiveness of orthopaedic robot-assisted minimally invasive surgery versus open surgery for limb osteoid osteoma.
METHODS
A clinical data of 36 patients with limb osteoid osteomas admitted between June 2016 and June 2023 was retrospectively analyzed. Among them, 16 patients underwent orthopaedic robot-assisted minimally invasive surgery (robot-assisted surgery group), and 20 patients underwent tumor resection after lotcated by C-arm X-ray fluoroscopy (open surgery group). There was no significant difference between the two groups in the gender, age, lesion site, tumor nidus diameter, and preoperative pain visual analogue scale (VAS) scores ( >0.05). The operation time, lesion resection time, intraoperative blood loss, intraoperative fluoroscopy frequency, lesion resection accuracy, and postoperative analgesic use frequency were recorded and compared between the two groups. The VAS scores for pain severity were compared preoperatively and at 3 days and 3 months postoperatively.
RESULTS
Compared with the open surgery group, the robot-assisted surgery group had a longer operation time, less intraoperative blood loss, less fluoroscopy frequency, less postoperative analgesic use frequency, and higher lesion resection accuracy ( <0.05). There was no significant difference in lesion resection time ( >0.05). All patients were followed up after surgery, with a follow-up period of 3-24 months (median, 12 months) in the two groups. No postoperative complication such as wound infection or fracture occurred in either group during follow-up. No tumor recurrence was observed during follow-up. The VAS scores significantly improved in both groups at 3 days and 3 months after surgery when compared with preoperative value ( <0.05). The VAS score at 3 days after surgery was significantly lower in robot-assisted surgery group than that in open surgery group ( <0.05). However, there was no significant difference in VAS scores at 3 months between the two groups ( >0.05).
CONCLUSION
Compared with open surgery, robot-assisted resection of limb osteoid osteomas has longer operation time, but the accuracy of lesion resection improve, intraoperative blood loss reduce, and early postoperative pain is lighter. It has the advantages of precision and minimally invasive surgery.
Topics: Humans; Robotics; Osteoma, Osteoid; Orthopedics; Blood Loss, Surgical; Retrospective Studies; Neoplasm Recurrence, Local; Minimally Invasive Surgical Procedures; Bone Neoplasms; Analgesics; Treatment Outcome
PubMed: 38225839
DOI: 10.7507/1002-1892.202310067 -
Molecular and Clinical Oncology Feb 2024Multiple osteochondromas (MOs) are inherited in an autosomal-dominant manner, with a penetrance of ~96 and 100% in female and male patients, respectively....
Multiple osteochondromas (MOs) are inherited in an autosomal-dominant manner, with a penetrance of ~96 and 100% in female and male patients, respectively. Osteochondromas primarily involve the metaphyses and diaphyses of long bones, including the ribs. Osteoid osteomas account for ~3 and 11% of all bone tumors and benign bone tumors, respectively. Furthermore,1 the male-to-female ratio is 2-3:1, and they generally occur in the long bones of the lower extremities, with the femoral neck being the most frequent site. The present study describes the case of a 16-year-old male patient with a bony mass around the left knee joint and pain in the left calf. Radiography revealed MOs in the upper and lower extremities, while computed tomography showed a nidus in the cortex of the tibial shaft. The patient's family history included the presence of MOs, and the patient was diagnosed with MOs and a solitary osteoid osteoma. Surgical excision of the osteochondroma and curettage of the osteoid osteoma in the proximal tibia and tibial shaft, respectively, were performed simultaneously. Postoperative pathological examination revealed osteochondroma and osteoid osteoma. Furthermore, the pain resolved, and no recurrence was observed 7 months post-operation. To the best of our knowledge, no reports exist on coexisting MOs and osteoid osteoma; therefore, the present study describes the first case of such a condition. Marginal excision for osteochondroma and curettage for osteoid osteoma effectively improved the symptoms.
PubMed: 38213658
DOI: 10.3892/mco.2023.2711 -
Journal of Orthopaedic Case Reports Dec 2023Osteoid osteoma is a common benign osteoblastic lesion of the bone. Although it commonly affects the cortex of long bones, it rarely involves the cancellous portion of...
INTRODUCTION
Osteoid osteoma is a common benign osteoblastic lesion of the bone. Although it commonly affects the cortex of long bones, it rarely involves the cancellous portion of the small bones such as phalanges. The occurrence of osteoid osteoma in phalanges poses a diagnostic dilemma.
CASE REPORT
In our case report, we presented a 26-year-old patient with long-standing pain over the great toe. The radiographs and magnetic resonance imaging (MRI) were unable to diagnose the lesion, and a single-photon emission computerized tomography scan picked up the nidus. She underwent radiofrequency ablation and post-procedure she was relieved of her symptoms.
CONCLUSION
Osteoid osteoma of the phalanges is uncommon, and at times, routine radiographs and MRIs might not point us to the correct diagnosis. As the prognosis is excellent after the treatment is instituted, osteoid osteoma should always be a differential in chronic foot pain with nocturnal predominance.
PubMed: 38162371
DOI: 10.13107/jocr.2023.v13.i12.4072 -
Musculoskeletal Surgery Mar 2024Osteoid osteoma is one of the most frequent benign musculoskeletal neoplasm. Radiofrequency ablation is the method of choice for non-conservative treatment of osteoid... (Review)
Review
Osteoid osteoma is one of the most frequent benign musculoskeletal neoplasm. Radiofrequency ablation is the method of choice for non-conservative treatment of osteoid osteoma. Recently, high-intensity focused ultrasound (HIFU) has been proposed as a safer option. The objective of this study is to review the efficacy and side effects of HIFU in the management of osteoid osteoma. A comprehensive search was conducted in PubMed, Science Direct, and Clinical Key until June 30, 2022. Demographic data, baseline characteristics, success rates, pre- and post-procedure pain scores, recurrences, and complications were recorded. Eleven studies were included in this systematic review. Pooled analysis that involved 186 subjects resulted in an overall success rate of 91.94%. Recurrence was reported in two studies, in which it occurred in 4/177 (2.26%) subjects. Skin burn was found in 1 (0.54%) patients. No major or other complications were reported. Three studies compared the success rate of HIFU and RFA. Success rate was slightly higher in the RFA group with insignificant difference (p = 0.15). High-intensity focused ultrasound showed promising results. It offers a safer treatment approach for osteoid osteoma, especially in children, and can be considered for recalcitrant cases after RFA. Nonetheless, more studies are expected in the future.
Topics: Child; Humans; Osteoma, Osteoid; Treatment Outcome; Bone Neoplasms; Musculoskeletal Diseases
PubMed: 38150115
DOI: 10.1007/s12306-023-00801-1 -
Clinical Pathology (Thousand Oaks,... 2023Only one article described ankle varus as a typical symptom in the late stage of the intra-articular osteoid osteoma of the calcaneus. And the red-brown color of...
BACKGROUND
Only one article described ankle varus as a typical symptom in the late stage of the intra-articular osteoid osteoma of the calcaneus. And the red-brown color of synovial fluid in the affected joint hasn't been reported. This report shows a patient with intra-articular osteoid osteoma of the calcaneus who had the 2 above symptoms.
CASE PRESENTATION
A 39-year-old man had left ankle pain and the diagnosis was delayed for 20 months. At the late stage, the ankle was gradually varus. In our hospital, the withdrawal of the subtalar joint gave a red-brown synovial fluid. Together with the typical lesion on MRI, the diagnosis of intra-articular osteoid osteoma of the calcaneus was made. An open operation was performed for treatment. In the procedure, the red-brown synovial fluid was exuded. A specimen was harvested for biopsy confirming osteoid osteoma.
CONCLUSIONS
It is still essential that intra-articular calcaneal osteoid osteoma should be considered in patients with prolonged pain and varus of the ankle. The red-brown synovial may be used as a finding for diagnosis.
PubMed: 38148754
DOI: 10.1177/2632010X231220198 -
Medicine Dec 2023Recently, cone-beam computed tomography (CBCT)-guided surgeries have been developed for bone and soft tissue tumors. The present study aimed to evaluate the efficacy of...
Recently, cone-beam computed tomography (CBCT)-guided surgeries have been developed for bone and soft tissue tumors. The present study aimed to evaluate the efficacy of CBCT-guided curettage for osteoid osteoma. Our study population included 13 patients who underwent primary curettage for osteoid osteoma using intraoperative CBCT in a hybrid operating room between April 2019 and November 2022. We collected the following data: sex, age, follow-up period, symptom onset to time of surgery, tumor size and location, length of skin incision, operating time, radiation dose, recurrence, postoperative complications, and visual analog scale for pain during the last follow-up. There were 10 male and 3 female patients, and the mean age was 25.0 years (range, 9-49 years). The mean follow-up period was 10.6 months (range, 0.4-24.0 months). The locations of the tumors were the proximal femur in 6 patients, the acetabular region in 2 patients, and the ilium, tibial shaft, calcaneus, cuboid, and talus in 1 patient each. The mean time of symptoms onset to surgery was 18.7 months (range, 2.3-69.9 months). The mean maximum diameter of the tumor was 5.9 mm (range, 3.5-10.0 mm). The mean length of the skin incision was 2.2 cm (range, 1.5-3.5 cm). The mean operating time was 96.9 minutes (range, 64-157 minutes). The mean dose of radiation was 193.2 mGy (range, 16.3-484.0 mGy). No recurrences, postoperative complications, and reoperation were observed in this study. All the patients reported 0 mm on the visual analogue scale for pain on the last follow-up. CBCT-guided curettage for osteoid osteoma was minimally invasive and reliable. This procedure can be effective for the treatment of lesions found in deep locations such as the pelvic bone and proximal femur or an invisible lesion that cannot be detected by regular fluoroscopy.
Topics: Humans; Male; Female; Adult; Osteoma, Osteoid; Tomography, X-Ray Computed; Radiography, Interventional; Bone Neoplasms; Cone-Beam Computed Tomography; Pain; Talus; Postoperative Complications; Calcaneus; Treatment Outcome
PubMed: 38134085
DOI: 10.1097/MD.0000000000036747