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Life (Basel, Switzerland) Jun 2023(1) Background: Osteoid osteoma (OO) is one of the most common benign bone tumors. This type of osteogenic tumor is generally characterized by a well-defined lytic area...
(1) Background: Osteoid osteoma (OO) is one of the most common benign bone tumors. This type of osteogenic tumor is generally characterized by a well-defined lytic area with a vascularized central nidus surrounded by sclerosis and bone thickening. The wrist and hand bones are infrequent sites for osteoid osteoma: only 10% of the cases arise in these areas. Standard treatments are surgical excision and radio-frequency ablation (RFA), both with advantages and disadvantages. This study aimed to compare the two techniques to prove if RFA could be a potential alternative to surgery in the treatment of OO of the hand. (2) Methods: Patients treated for OO of the hand between January 2011 and December 2020 were evaluated and data was collected regarding the lesions' characteristics and the treatment outcome. Each patient was followed up for 24 months and VAS pain (Visual Analogue Scale), DASH (Disability of the Arm, Shoulder and Hand), and PRWE (Patient-Related Wrist Evaluation) scores were collected. (3) Results: A total of 27 patients were included in the study: 19 surgical and 8 RFA. Both treatments showed a significant improvement in pain and functionality. Surgery was associated with a higher complication rate (stiffness and pain), while RFA was associated with a higher recurrence rate (2/8 patients). RFA allowed for a speedier return to work. (4) Conclusions: We believe that osteoid osteoma treatment with RFA in the hand should be an available alternative to surgery as it allows rapid pain relief and a swift return to work. Surgery should be reserved for cases of diagnostic uncertainty or periosteal localization.
PubMed: 37374133
DOI: 10.3390/life13061351 -
BMC Musculoskeletal Disorders Jan 2017Osteoid osteoma (OO) is a common benign bone tumour that is rarely found in the talus. Its nidus is difficult to detect on early imaging. The atypical symptoms of OO and... (Review)
Review
BACKGROUND
Osteoid osteoma (OO) is a common benign bone tumour that is rarely found in the talus. Its nidus is difficult to detect on early imaging. The atypical symptoms of OO and the presence of concurrent trauma or sports injuries may lead to misdiagnosis and delayed treatment. We herein analyse a case of misdiagnosis of OO of the talus and discuss how to improve the early diagnosis of this rare lesion, thereby permitting rapid treatment.
CASE PRESENTATION
A 23-year-old man with a history of left ankle sprains and chronic pain was diagnosed with another ankle sprain and managed conservatively based on normal X-ray findings. After 1 year of recurring pain, he was diagnosed with ankle traumatic arthritis and underwent arthroscopic surgery. His preoperative ankle X-ray findings were still normal, and magnetic resonance imaging at that time demonstrated bone marrow oedema of the left talus. His symptoms reappeared shortly after surgery and progressively worsened. Magnetic resonance imaging performed 3 months after surgery demonstrated widespread bone marrow oedema of the talus. The patient presented to our hospital for pain assessment and was diagnosed with OO of the talus 3 years after his symptoms began. Preoperative computed tomography (CT) demonstrated a typical nidus of OO of the talus. After a second surgery, the patient's symptoms completely resolved, and pathologic examination confirmed that the lesion was OO. The patient recovered 3 months later and was able to walk normally.
CONCLUSIONS
OO of the ankle joint exhibits a progressive course and is difficult to diagnose at an early stage. Patients with OO of the talus often have atypical imaging findings, no signs of ankle instability, and no anterior talofibular ligament tenderness. CT is valuable for diagnosing OO, although multiple CT scans may be required to detect the nidus. Proper imaging helps doctors to achieve the correct diagnosis early in the disease course, significantly shortening the treatment cycle and improving the patient's quality of life.
Topics: Bone Neoplasms; Diagnostic Errors; Follow-Up Studies; Humans; Male; Osteoma, Osteoid; Talus; Young Adult
PubMed: 28114974
DOI: 10.1186/s12891-017-1413-8 -
Osteoid osteoma of the second metatarsal bone diagnosed on MRI: A case report and literature review.Radiology Case Reports Mar 2022Osteoid osteoma is a relatively common benign bone tumor that is most frequently seen on the appendicular skeleton in adolescents and young adults. Here we present the...
Osteoid osteoma is a relatively common benign bone tumor that is most frequently seen on the appendicular skeleton in adolescents and young adults. Here we present the case of a 14-year-old boy presenting with a 10 month history of pain in his left foot which had been misdiagnosed as stress fracture due to its unusual clinical presentation. Magnetic resonance imaging of the left foot revealed a bone lesion with typical features of the osteoid osteoma on the distal part of the second metatarsal bone. The lesion was surgically removed and the diagnosis of osteoid osteoma was confirmed by post-surgical histopathologic examination of the resected section. The patient reported a substantial relief in his pain 4 weeks following the surgical operation.
PubMed: 34917221
DOI: 10.1016/j.radcr.2021.11.014 -
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 -
RoFo : Fortschritte Auf Dem Gebiete Der... Jul 2024
Topics: Humans; Osteoma, Osteoid; Delayed Diagnosis; Bone Neoplasms; Male; Female; Adolescent; Adult; Tomography, X-Ray Computed; Young Adult; Magnetic Resonance Imaging; Child; Diagnosis, Differential; Middle Aged
PubMed: 37995734
DOI: 10.1055/a-2203-2823 -
Orthopaedic Surgery May 2022To analyze the causes of misdiagnosis and missed diagnosis in spinal osteoid osteoma, and to put forward solutions to improve diagnosis accuracy and treatment efficacy...
OBJECTIVES
To analyze the causes of misdiagnosis and missed diagnosis in spinal osteoid osteoma, and to put forward solutions to improve diagnosis accuracy and treatment efficacy in patients.
METHODS
We performed a retrospective cohort study on patients with spinal osteoid osteoma in Beijing Jishuitan Hospital from January 1983 to September 2019. All patients underwent surgery. The outcome measures were the extent of local pain, nocturnal pain, radicular symptoms of extremities after surgery, and reduction or disappearance of lesions on CT after surgery.
RESULTS
Thirty-seven patients with spinal osteoid osteoma were recruited in the study. A total of 27% were female, and the mean (SD) age at diagnosis was 21.3 (8.7) years. A total of 87.0% of patients presented with nocturnal pain, and 94.7% of patients were responsive to NSAIDS treatment. The mean (SD) time from the initial onset of symptoms to the final diagnosis was 14.7 (12.5) months. Only four of 37 (10.8%) patients were correctly diagnosed with spinal osteoid osteoma on the first visit to the local hospital. CT is associated with a higher diagnosis rate than X-ray or MRI on the first visit. Surgical navigation was used in 88.9% of patients who underwent curettage resection, and in 10% of patients who underwent en bloc resection. A total of 37 of 37 patients (100%) reported relief of local pain and radicular symptoms of extremities after surgery, and no recurrence of tumors was found during follow-ups.
CONCLUSIONS
Spinal CTs are recommended to be performed if osteoid osteoma is suspected based on clinical manifestation, including nocturnal pain and responsiveness to NSAIDS treatment, to avoid misdiagnosis and missed diagnosis of spinal osteoid osteoma.
Topics: Anti-Inflammatory Agents, Non-Steroidal; Bone Neoplasms; Diagnostic Errors; Female; Humans; Male; Missed Diagnosis; Osteoma, Osteoid; Pain; Retrospective Studies; Spinal Neoplasms
PubMed: 35434964
DOI: 10.1111/os.13280 -
Indian Journal of Orthopaedics Jun 2023Osteoid osteoma occurs in various locations in the human body, mostly in the metaphysis and diaphysis of long bones. This article describes a rare case of osteoid...
Osteoid osteoma occurs in various locations in the human body, mostly in the metaphysis and diaphysis of long bones. This article describes a rare case of osteoid osteoma occurring in an intra-articular location, specifically in the lateral tibial plateau of a 40-year-old female patient. The challenge of diagnosing such a pathology in an atypical location was tackled in this article as well as different management options. Arthroscopic resection was opted in this case.
PubMed: 37214377
DOI: 10.1007/s43465-023-00886-7 -
International Orthopaedics Apr 2006Osteoid osteoma is a benign bone tumour usually occurring in young individuals (10-30 years). It presents with intense pain (typically nocturnal), which can be... (Review)
Review
Osteoid osteoma is a benign bone tumour usually occurring in young individuals (10-30 years). It presents with intense pain (typically nocturnal), which can be alleviated by salicylates. Treatment consists of surgical excision or destroying the nidus and it is curative. In the past, surgery was performed in an "open" fashion and the nidus had to be removed with a bone block. This extensive type of surgery could be associated with some rates of both failure and complication. There is growing evidence to suggest that percutaneous CT-guided removal or destruction of the nidus is a good alternative and it is indeed gaining worldwide popularity. We present a series of 18 consecutive patients with osteoid osteoma of the pelvis, femur, and tibia, treated percutaneously under CT guidance. Removal of the nidus was performed using a 4.5-mm cannulated drill and a cannulated curette of our own design. Tissue samples for histological evaluation were obtained in the same way. The mean follow-up time was 29 months. Sixteen patients were initially cured. The procedure had to be repeated in two patients and was eventually successful (primary and secondary success rates 88 and 100% respectively). The diagnosis was histologically confirmed in 14 cases out of 18 (77%). In four cases no histological confirmation of osteoid osteoma could be achieved. There were only two minor complications, one case of femoral neuropraxia and one case of skin abrasion. Percutaneous CT-guided removal seems to be efficient and safe for the treatment of osteoid osteoma. The use of a cannulated drill and a cannulated curette facilitates efficient removal of the tumour and procurement of tissue for diagnosis.
Topics: Adolescent; Adult; Child; Curettage; Female; Humans; Male; Osteoma, Osteoid; Radiography, Interventional; Retrospective Studies; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 16474938
DOI: 10.1007/s00264-005-0051-1 -
Cureus Jul 2022Osteoid osteomas are benign primary bone lesions characterized by a central nidus with surrounding reactive sclerosis, classically presenting as worsening nocturnal pain...
Osteoid osteomas are benign primary bone lesions characterized by a central nidus with surrounding reactive sclerosis, classically presenting as worsening nocturnal pain relieved by non-steroidal anti-inflammatory medications (NSAIDs). These most commonly occur in intracortical bone and the diaphysis of long bones. As a rare entity, intra-articular osteoid osteomas present unusually, often resulting in a delayed or incorrect diagnosis. We present a case of an intra-articular osteoid osteoma, emphasizing the importance of MRI in aiding diagnosis in this atypical location.
PubMed: 36060340
DOI: 10.7759/cureus.27484 -
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