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Nachu M, Tontanahal S, Kurian BT. Osteoid osteoma of the distal radius presenting as an inconspicuous swelling in a young child. BMJ Case Rep 2024; 17:e259712. [PMID: 38569739 PMCID: PMC10989157 DOI: 10.1136/bcr-2024-259712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Abstract
Osteoid osteoma is a benign osteoblastic tumour with a predilection for the lower extremity that rarely affects the forearm. It is commonly seen in adolescents and young adults, and is seldom diagnosed in the paediatric age group. We report a boy in his early childhood who presented with a swelling over the distal forearm, which was incidentally noted by the mother 3 months ago. Plain radiographs showed diffuse sclerosis of the dorsal cortex of the distal radius. CT scan showed a central lucent nidus in the intramedullary region and surrounding sclerosis in the radial metaphysis, confirming the diagnosis of osteoid osteoma. The patient was successfully treated by surgical en bloc resection of the nidus and was asymptomatic at 1-year follow-up. Non-specific symptoms at presentation make it a challenge to diagnose osteoid osteoma in children and it needs to be considered in the differential diagnosis when radiographs show lytic lesions in the bone.
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Affiliation(s)
- Monish Nachu
- Orthopaedics, St John's Medical College Hospital, Bangalore, Karnataka, India
| | - Sagar Tontanahal
- Orthopaedics, St John's Medical College Hospital, Bangalore, Karnataka, India
| | - Binu T Kurian
- Orthopaedics, St John's Medical College Hospital, Bangalore, Karnataka, India
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2
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Daher M, Roukoz S, Pearl A, Saleh K. Osteoid osteoma of the wrist: Recent advances. HAND SURGERY & REHABILITATION 2023; 42:386-391. [PMID: 37182838 DOI: 10.1016/j.hansur.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 04/18/2023] [Accepted: 05/04/2023] [Indexed: 05/16/2023]
Abstract
Osteoid osteoma is a benign bone tumor usually arising in the diaphysis and metaphysis of the long bones, with male predominance (sex ratio, 2:1). Despite being the most common bone tumor in the wrist, it is still an atypical location for this lesion. The usual presentation is pain that is exacerbated at night and relieved by aspirin or non-steroidal anti-inflammatory drugs. This presentation is not always the case in the wrist, which leads to numerous differential diagnoses and often a delay in definitive diagnosis and treatment. Various imaging modalities can confirm the presence of the tumor and guide the surgical approach. Resection is the gold-standard, with radiofrequency gaining popularity in recent years.
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Affiliation(s)
- Mohammad Daher
- Saint Joseph University, Hotel Dieu de France, Beirut, Lebanon
| | - Sami Roukoz
- Saint Joseph University, Hotel Dieu de France, Beirut, Lebanon
| | - Adam Pearl
- Wayne State University School of Medicine, Detroit, MI, USA; John D Dingell Veterans Affairs Medical Center, Detroit, MI, USA
| | - Khaled Saleh
- John D Dingell Veterans Affairs Medical Center, Detroit, MI, USA.
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Tilden W, Lindsay D, Astrinakis E, Horwitz M, Saifuddin A. A 29-year-old male with a long history of atraumatic wrist pain. Skeletal Radiol 2021; 50:2125-2126. [PMID: 33712878 DOI: 10.1007/s00256-021-03743-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 02/09/2021] [Accepted: 02/14/2021] [Indexed: 02/02/2023]
Affiliation(s)
- William Tilden
- The Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, HA7 4LP, UK.
| | - Daniel Lindsay
- The Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, HA7 4LP, UK
| | | | | | - Asif Saifuddin
- The Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, HA7 4LP, UK
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Swank KR, Baker EA, Gehrke CK, Rohde RS. Surgical Management of Triquetral Osteoid Osteoma with Adjunct Tetracycline for Intraoperative Visualization: A Case Report. JBJS Case Connect 2020; 10:e20.00132. [PMID: 33512929 DOI: 10.2106/jbjs.cc.20.00132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CASE We report the case of a 15-year-old male patient presenting with persistent wrist pain after surgical treatment of a triquetral osteoid osteoma. The patient was found to have a persistent nidus. These tumors are difficult to observe intraoperatively or through fluoroscopy, limiting adequate resection and resulting in continued pain. CONCLUSION The nidus was excised successfully through an unusual technique using tetracycline for intraoperative identification. The patient remains asymptomatic without recurrence at 31 months postoperative. Difficulties visualizing and removing carpal lesions leading to recurrence are described.
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Affiliation(s)
- Katherine R Swank
- Department of Orthopaedic Surgery, Beaumont Health, Royal Oak, Michigan
| | - Erin A Baker
- Department of Orthopaedic Research, Beaumont Health, Royal Oak, Michigan.,Department of Orthopaedic Surgery, Oakland University William Beaumont School of Medicine, Rochester, Michigan
| | - Corinn K Gehrke
- Department of Orthopaedic Research, Beaumont Health, Royal Oak, Michigan
| | - Rachel S Rohde
- Department of Orthopaedic Surgery, Beaumont Health, Royal Oak, Michigan.,Department of Orthopaedic Surgery, Oakland University William Beaumont School of Medicine, Rochester, Michigan
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Proximal Phalanx Osteoid Osteoma: A Case Report and Literature Review. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2017; 5:e1332. [PMID: 28607858 PMCID: PMC5459641 DOI: 10.1097/gox.0000000000001332] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 03/21/2017] [Indexed: 11/25/2022]
Abstract
Osteoid osteoma is a rare clinical entity often mistaken for osteomyelitis, enchondroma, osteochondroma and other bony pathologies. Cardinal features include localized swelling and nocturnal pain often relieved by nonsteroidal antiinflammatory drugs. Definitive treatment requires surgical removal of the lesion by curettage or en bloc excision. The following case report details the diagnosis and management of a recurrent case of osteoid osteoma in a long finger proximal phalanx. Included with this case report is a literature review of osteoid osteomas on the hand and the anatomic distribution of 289 cases published in the last 30 years.
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Abstract
Carpal osteoid osteomas are extremely rare, and only six cases in the pisiform have ever been described, but all concerned exclusively adults. We have treated a unique case of osteoid osteoma in the pisiform of a 13-year-old girl. We excised en bloc the nidus, which resulted in total excision of the pisiform. At follow-up after 15 years there was no recurrence and the patient remains asymptomatic with equal functionality of both hands. Henceforth, we must include osteoid osteoma in the differential diagnosis of pisiform lesions in children. En bloc resection prevents its recurrence and even the complete pisiform excision renders excellent results.
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Zoubir E, Frikha F, Trigui M, Bouaziz W, Ayedi L, Aoui M, Gdoura F, Dabbeh C, Bahloul Z, Boudawara T, Ayedi K, Keskes H. [Intra-articular osteoid osteoma of the hip: two cases and review of the literature]. Pan Afr Med J 2011; 8:5. [PMID: 22121414 PMCID: PMC3221407 DOI: 10.4314/pamj.v8i1.71051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2010] [Accepted: 01/30/2011] [Indexed: 11/17/2022] Open
Abstract
Abstract L’ostéome ostéoïde est une tumeur osseuse bénigne qui affecte les adultes jeunes et se localise préférentiellement au niveau des os longs. La localisation intra-articulaire est rare et atteint le plus souvent la hanche. La symptomatologie clinique est alors atypique et peut faire errer le diagnostic constituant un défi diagnostique pour les cliniciens. Nous rapportons deux observations d’ostéome ostéoïde intra-articulaires de la hanche chez deux hommes âgés 24 et 45 ans, révélés par des douleurs de la hanche gauche de type inflammatoire évoluant depuis un an et un an et demi respectivement. Chez les deux patients, le tableau atypique de l’ostéome ostéoïde a été à l’origine d’un retard diagnostic. La tomodensitométrie est dans cette indication l’examen le plus spécifique qui a permis d’évoquer le diagnostic d’ostéome ostéoïde. Une fois le diagnostic est posé, l’exérèse chirurgicale à ciel ouvert a permis la guérison avec disparition totale des douleurs. L’examen histologique a confirmé le diagnostic final d’ostéome ostéoïde intra-articulaire dans les deux cas.
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Affiliation(s)
- Ellouz Zoubir
- Service d'Orthopédie et Traumatologie CHU Habib Bourguiba 3029 Sfax, Tunisia
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Thomsen L, Dumontier C. Osteoid osteoma of the pisiform: A case report. ACTA ACUST UNITED AC 2011; 30:76-9. [DOI: 10.1016/j.main.2010.07.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2009] [Revised: 07/01/2010] [Accepted: 07/02/2010] [Indexed: 10/19/2022]
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Osteoid osteoma of the trapezium: case report. J Hand Surg Am 2010; 35:636-8. [PMID: 20171814 DOI: 10.1016/j.jhsa.2009.12.032] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2009] [Revised: 12/19/2009] [Accepted: 12/22/2009] [Indexed: 02/02/2023]
Abstract
Osteoid osteoma is a benign bone tumor representing approximately 10% of all benign bone tumors. Although osteoid osteoma of the long bones and carpus is frequent, the location in the trapezium is extremely rare. We found only one other report in the literature regarding osteoid osteoma of the trapezium.
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Laffosse JM, Tricoire JL, Cantagrel A, Wagner A, Puget J. Osteoid osteoma of the carpal bones. Two case reports. Joint Bone Spine 2006; 73:560-3. [PMID: 16904929 DOI: 10.1016/j.jbspin.2005.11.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2005] [Accepted: 11/30/2005] [Indexed: 10/24/2022]
Abstract
Osteoid osteoma rarely develops in the wrist. The symptoms resemble atypical tenosynovitis, with variations according to the location of the tumor. As a result, diagnostic wanderings are common. In addition, the pain may seem related to an injury, as illustrated by two cases reported herein. Conventional investigations often fail to contribute to the diagnosis. The most specific investigation is thin-slice computed tomography (CT), which can be coupled to magnetic resonance imaging. CT typically visualizes a round lucency surrounded by a rim of sclerosis; in addition, CT shows the exact location of the tumor, particularly relative to neighboring joints. Complete excision of the nidus must be achieved to ensure a permanent cure. Same-stage carpal bone fusion may be required in patients with extensive joint involvement.
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Affiliation(s)
- Jean-Michel Laffosse
- Service d'Orthopédie et de Traumatologie, CHU de Rangueil, 1, avenue Jean Poulhès TSA 50032, 31059 Toulouse cedex 9, France.
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Themistocleous GS, Chloros GD, Benetos IS, Efstathopoulos DG, Gerostathopoulos NE, Soucacos PN. Osteoid osteoma of the upper extremity. A diagnostic challenge. ACTA ACUST UNITED AC 2006; 25:69-76. [PMID: 16841767 DOI: 10.1016/j.main.2006.02.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Osteoid osteomas are benign tumors that may commonly mimic other entities in the upper extremity. The purpose of this study is to describe the clinical and imaging features of osteoid osteomas involving the upper extremity, highlight the difficulties in the diagnosis in the various areas and propose a diagnostic workup. Fourty-eight patients with histologically confirmed osteoid osteoma of the upper extremity treated at the authors' department from 1985 to 2000 were retrospectively reviewed. Data pertinent on the patients' history, lesion location, clinical and imaging characteristics as well as any unique features of individual patients were collected. There were 29 males and 19 females with a mean age of 28 years (range 20-42). The average duration of symptoms before definite diagnosis was 18 months (range 2-62). Pain was the presenting symptom in 46 of 48 patients, whereas swelling was the main complaint in 2 of the patients. Mean pre-operative visual analogue pain scale (VAS), was 8.8 ranging from 5.1 to 9.3. Eight lesions were located in the humerus, 4 in the ulna and 7 in the radius. In the carpal bones, 4 were located in the scaphoid, 4 in the capitate and 5 in the hamate. Seven lesions were located at the metacarpals and 9 lesions at the phalanges (5 proximal, no middle and 4 distal phalangeal lesions). Radiographs alone were sufficient to establish the diagnosis of osteoid osteoma in 32 cases. Bone scans identified a "hot spot" in 16 patients without previous radiographic evidence of a lesion and furthermore, computed tomography was performed in 32 patients to assist in the intraosseous localization of the lesion, and in the pre-operative planning. All patients underwent operative excision of the lesion and the diagnosis was confirmed by histology. Mean follow-up was 28 months (range 25-42). Fourty-three patients had an uneventful recovery. Mean post-operative VAS value was 1.8 ranging from 0 to 3. Osteoid osteoma of the upper extremity often mimics other etiologies and the complex anatomy of the upper extremity, as well as the tendency of patients to relate their symptoms to trauma are factors that easily lead to misdiagnosis or delay in the diagnosis. A high index of suspicion is essential and the diagnosis is based on an accurate clinical assessment and careful selection of imaging studies.
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Affiliation(s)
- G S Themistocleous
- Department of Hand Surgery and Microsurgery, KAT Hospital, 2 Nikis Street, 145 61 Athens, Greece.
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Girard J, Becquet E, Limousin M, Chantelot C, Fontaine C. Ostéome ostéoïde de l'os trapézoïde : à propos d'un cas et revue de la littérature. ACTA ACUST UNITED AC 2005; 24:35-8. [PMID: 15754709 DOI: 10.1016/j.main.2004.11.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Osteoid osteomas are often localised in long bones but only rarely in the carpus. This is a case report of an osteoid osteoma in the trapezoid. Diagnosis was difficult and established late, due to misleading initial symptoms. Radiological examination allowed localisation of the nidus. For osteoid osteoma localised in a carpal bone, we recommend total removal without bone-graft or arthrodesis.
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Affiliation(s)
- J Girard
- Service d'orthopédie C, clinique d'orthopédie Pierre-Decoulx, hôpital Roger-Salengro, CHRU de Lille, 59037 Lille cedex, France.
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