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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 -
Journal of Orthopaedics Sep 2018Osteoid osteoma is an uncommon benign tumor and causes severe pain, being worse at night, that responds dramatically to nonsteroidal anti-inflammatory medications. An... (Review)
Review
Osteoid osteoma is an uncommon benign tumor and causes severe pain, being worse at night, that responds dramatically to nonsteroidal anti-inflammatory medications. An osteoid osteoma of the patella is very rare and if it arise close to chondral surface differential diagnosis may be challenging. In three patients the osteoid osteoma was completely excised by nidus removal by mosaicoplasty set with open surgical technique. The patients were followed up in average for 31 (16-48 months) months with annual clinical and radiographic evaluations. There were no relapse of the pain and no residual recurrent tumor. The aim of the treatment for osteoid osteoma is to remove entire nidus by open surgical excision or by percutaneous procedures such as percutaneous radiofrequency and laser ablation. Mosaicoplasty is a good alternative for treatment of osteoid osteoma of the patella in the subchondral bone.
PubMed: 29946202
DOI: 10.1016/j.jor.2018.05.036 -
Polish Journal of Radiology 2020Diagnosis of osteoid osteoma may be delayed if secondary radiological findings such as muscle atrophy, oedema in peripheric soft tissue and bone marrow, joint effusion,...
PURPOSE
Diagnosis of osteoid osteoma may be delayed if secondary radiological findings such as muscle atrophy, oedema in peripheric soft tissue and bone marrow, joint effusion, or synovitis are more severe than the lesion itself. In this article, the purpose was to demonstrate secondary radiological findings of osteoid osteoma in both paediatric and adult patients. This study is one of the very few with such a large case series.
MATERIAL AND METHODS
Radiological images of 152 patients were reviewed retrospectively. Peri-nidus sclerosis, periosteal reactive bone formation, bone marrow and soft tissue oedema, presence of synovial effusion, muscular atrophy in the affected extremity, osteopaenia, and posture deterioration were noted.
RESULTS
Most of the lesions (87.5%) were localised in lower extremity bones. Among all the patients, 56% had extra-articular (65% in paediatric patients) and 44% had intraarticular (69% in paediatric patients) osteoid-osteoma. In 44% of the patients, synovial effusion was presented. In 89.4% of these, osteoid osteoma was localised in the joint. Of the 97 patients who had osteoid osteoma in lower extremities or pelvic bones, 73% had muscular atrophy. In 6% of them muscular atrophy was severe, and they had posture-gait disorder with accompanying osteopaenia. In 48% of the patients, there was reactive periosteal bone formation around the nidus.
CONCLUSIONS
Secondary radiological findings, such as muscular atrophy, synovitis, posture-gait deterioration, and reactive bone formation in a patient with continuous pain that is relieved by anti-inflammatory drugs may point to an osteoid osteoma.
PubMed: 32685067
DOI: 10.5114/pjr.2020.97007 -
Orthopaedics & Traumatology, Surgery &... Oct 2014Osteoid osteoma is a benign osteogenic tumor that is mainly located in the lower limbs. According to Campanacci the proximal femur is involved in 25% of cases. We...
INTRODUCTION
Osteoid osteoma is a benign osteogenic tumor that is mainly located in the lower limbs. According to Campanacci the proximal femur is involved in 25% of cases. We present a series of 44 cases of osteoid osteoma located in the neck of the femur or the lesser trochanter treated by the minimally invasive method, CT-guided percutaneous bone resection and drilling (PBRD).
MATERIALS AND METHODS
This series included 44 patients, 20 girls and 24 boys, treated between 1987 and 2012. The average age at surgery was 12.7 years old (range 4-34). The diagnosis was based on the "association" of scintigraphy (hyperfixation) - CT scan (nidus located on the femoral neck or near the lesser trochanter). These patients underwent CT-guided PBRD under general anesthesia. Specific ancillary material was used to reach and remove the nidus and a cylinder of bone was sent to the pathologist for assessment. A lateral or anterior approach was used in all cases except one in which a posterior incision was made. Histological confirmation was obtained in 23 cases (the bone fragment was damaged in 21 cases).
RESULTS
Forty-two patients were reviewed after a minimum follow-up of one year (12-56 months). Two patients were lost to follow-up. Results were evaluated clinically and on CT scan 1 year after surgery: there were 35 cures with complete and permanent pain relief. There were 5 failures and 1 case of recurrence requiring a second CT-guided PBRD procedure as well 2 complications involving femoral fracture (one associated with failure).
DISCUSSION
The proximal femur is a common location of osteoid osteoma. Treatment requires careful preoperative planning to determine the surgical approach for safe removal. PBRD is a minimally invasive technique, allowing complete resection with suitable ancillary equipment. This method should be compared with thermoablation, which is a similar technique.
CONCLUSION
CT-guided PBRD is a therapeutic option in case of osteoid osteoma of the proximal femur.
LEVEL OF EVIDENCE
Level IV.
Topics: Adolescent; Adult; Bone Neoplasms; Child; Child, Preschool; Female; Femur; Follow-Up Studies; Humans; Male; Osteoma, Osteoid; Postoperative Complications; Radiography, Interventional; Tomography, X-Ray Computed; Young Adult
PubMed: 25217029
DOI: 10.1016/j.otsr.2014.05.017 -
The Indian Journal of Radiology &... Jun 2022Osteoid osteomas are mostly solitary. We report a case of metachronous osteoid osteoma of mid-diaphysis of fibula followed by distal humeral osteoid osteoma after a...
Osteoid osteomas are mostly solitary. We report a case of metachronous osteoid osteoma of mid-diaphysis of fibula followed by distal humeral osteoid osteoma after a 7-year interval.
PubMed: 35924137
DOI: 10.1055/s-0042-1744163 -
Asian Spine Journal Jun 2014The prevalence of back pain during childhood is 50%; in 22% of these cases, a specific diagnosis can be found. Osteoid osteoma is a rare benign tumor that occursonly in...
The prevalence of back pain during childhood is 50%; in 22% of these cases, a specific diagnosis can be found. Osteoid osteoma is a rare benign tumor that occursonly in 20% of cases and involves the spine. The aim of this report is to explain an atypical case of lumbar osteoid osteoma with significant neurologic deficit at a very young age. A five-year-old boy was presented with refractory pain in the low back and left extremity for approximately one year. Positive clinical findings were antalgic gait, stiff lumbar spine, weak left big toe extension force and a positive straight leg rising test on the left side. Paraclinical studies revealed osteoid osteoma in the left-sided pedicle of the fifth lumbar vertebra. With surgical excision, he recovered immediately. Lumbar osteoid osteoma should be suspected as the cause of low back pain or sciatalgia in any young patient.
PubMed: 24967051
DOI: 10.4184/asj.2014.8.3.357 -
BMC Musculoskeletal Disorders Jan 2019Osteoid osteoma is a painful benign skeletal tumour of unknown aetiology. Most often it occurs in the long bones of extremities and responds well to nonsteroidal...
BACKGROUND
Osteoid osteoma is a painful benign skeletal tumour of unknown aetiology. Most often it occurs in the long bones of extremities and responds well to nonsteroidal anti-inflammatory medications. However, unusual localization and atypical presentation of this tumour might present a diagnostic challenge, especially if symptoms mimic that indicative of juvenile spondyloarthritis.
CASE PRESENTATION
A misdiagnosed ten-and-a-half-year-old girl with osteoid osteoma involving the distal phalanx of a little finger is presented. Her initial symptoms were pain and swelling of the little finger resembling dactylitis, while various imaging modalities showed signs of tenosynovitis, indicating a possible development of juvenile spondyloarthritis. Several trials of different non-steroid anti-inflammatory drugs gave no satisfactory results and ultrasound guided triamcinolone-hexacetonide injection provided only a short relief. Finally, almost three years after initial presentation, persistent clinical symptoms warranted repeated imaging that raised suspicion of an osteoid osteoma. Directed treatment with surgical intervention led to almost immediate and complete resolution of her symptoms.
CONCLUSIONS
Osteoid osteoma should be suspected in case of a tender swelling of a digit in children and adolescents, regardless of initial imaging findings and clinical presentation. Early diagnosis and treatment of this benign condition can have a substantial impact on quality of life of patients and their families and protect them from many unnecessary diagnostic procedures and treatment.
Topics: Anti-Inflammatory Agents, Non-Steroidal; Arthritis, Juvenile; Bone Neoplasms; Child; Diagnosis, Differential; Diagnostic Errors; Female; Finger Phalanges; Humans; Magnetic Resonance Imaging; Osteoma, Osteoid; Pain; Treatment Outcome
PubMed: 30621690
DOI: 10.1186/s12891-018-2383-1 -
Journal of Medical Case Reports Aug 2008Osteoid osteoma is a benign tumor of the growing skeleton. It presents with pain, which is usually worse at night. The radiographic features consist of a central oval or...
INTRODUCTION
Osteoid osteoma is a benign tumor of the growing skeleton. It presents with pain, which is usually worse at night. The radiographic features consist of a central oval or round nidus surrounded first by a radiolucent area followed by another area of sclerotic bone. In the hand, osteoid osteoma is more commonly located in the phalanges and carpal bones. The metacarpals are the least common sites for osteoid osteoma.
CASE PRESENTATION
We present a case of an osteoid osteoma of the left third metacarpal bone in a 36-year-old woman. The clinical and radiographic findings along with the surgical management of the lesion are presented. The pain disappeared immediately after the operation. At the 2-year follow-up, the patient was pain-free and there was no evidence of recurrence.
CONCLUSION
Physicians should be aware of the unusual presence and the atypical clinical presentation of this benign lesion in the metacarpal bones of the hand.
PubMed: 18752665
DOI: 10.1186/1752-1947-2-285 -
Medicine Nov 2016Lumbar osteoid osteoma has a low incidence, which could easily lead to scoliosis. (Review)
Review
RATIONALE
Lumbar osteoid osteoma has a low incidence, which could easily lead to scoliosis.
PATIENT CONCERNS
Scoliosis secondary to lumbar osteoid osteoma could be easily misdiagnosed when patients do not complain of obvious symptoms.
DIAGNOSES
We reported a case of a 9-year-old boy with back deformity that was firstly diagnosed with scoliosis at the local hospital. After prescribed with orthosis, the patient experienced aggravating pain that could not be relieved with painkillers. After he admitted to our hospital for further medical advice, he was prescribed to complete radiological examinations. Considering his radiological examination results and his medical history, correct diagnosis of lumbar osteoid osteoma was made.
INTERVENTIONS
Surgical intervention of posterior lesion resection was conducted after diagnosis. Intra-operative frozen pathology indicated features of osteoid osteoma. As the lesion involved inferior articular process of L5, which could cause lumbar instability after lesion resection, internal fixation was conducted at L4-S1 segment, and posterolateral bone fusion was also conducted at L5-S1 segment.
OUTCOMES
Three months after operation, the patient showed marked improvement of scoliosis deformity and great relief of lumbar pain.
LESSONS SUBSECTIONS
Although spine osteoid osteoma is clinically rare, it shall not be overlooked when young patients present with scoliosis first. Radiological results including computed tomography and magnetic resonance imaging shall be taken carefully as reference when making diagnosis. Surgical intervention of lesion resection could well improve scoliosis and relieve lumbar pain.
Topics: Child; Delayed Diagnosis; Humans; Lumbar Vertebrae; Male; Osteoma, Osteoid; Scoliosis; Spinal Neoplasms
PubMed: 27893671
DOI: 10.1097/MD.0000000000005362 -
Asian Spine Journal Apr 2014Descriptive, cases series study.
STUDY DESIGN
Descriptive, cases series study.
PURPOSE
To evaluate clinical findings and results of treatment of patients with spinal osteoid osteoma who underwent surgery.
OVERVIEW OF LITERATURE
Osteoid osteoma is a benign tumor with spinal involvement rate of about 10%. It is manifested during adolescence with symptoms such as painful scoliosis. To treat the problem, operation on the patients and excising the nidus are suggested.
METHODS
This descriptive study was conducted on 11 patients with spinal osteoid osteoma at our orthopedic educational center. All patients were treated through open surgery and nidus curettage. All samples were pathologically confirmed. Imaging methods (spiral computed tomography-scan) was used in preoperative planning. Scoliosis and other clinical findings were studied.
RESULTS
The study was conducted on 11 patients comprising 6 females (54.5%) and 5 males (45.5%) with the mean age of 14.6 years. Mean deviation of scoliosis resulting from spinal osteoid osteoma was 22.8 degrees. There was more scoliosis in the involvement of the lumbar vertebra. In comparison with adults, scoliosis was more severe in youths. There was one case of vertebra body involvement with manifestation of painful scoliosis. Due to lack of careful preoperative examination, the surgery was repeated for this case. No sign of recurrence was observed in patients who underwent open surgery and all scoliosis in the follow-up had improved.
CONCLUSIONS
Based on our findings, surgical excision of spinal ostoeid osteoma was successful and complete recovery was achieved in spinal deformity in the course of follow-up. Scoliosis is often seen during adolescence and lumbar involvement is more severe.
PubMed: 24761196
DOI: 10.4184/asj.2014.8.2.150