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Maselli F, Storari L, Lorusso M, Mourad F, Pennella D, Barbari V, Salomon M, Brindisino F. Osteoid Osteoma in an Adult Wheelchair Basketball Player Mimicking Musculoskeletal Shoulder Pain: Red Flag or a Red Herring? Tomography 2022; 8:389-401. [PMID: 35202197 PMCID: PMC8877604 DOI: 10.3390/tomography8010032] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 01/13/2022] [Accepted: 01/29/2022] [Indexed: 12/01/2022] Open
Abstract
Osteoid osteoma (OO) is a relatively common, benign bone-forming tumour, which mainly occurs on the long tubular bones of the limbs in adolescents. Usually, the OO is classified based on its localisation. Night-time pain is the major symptom of OO, which is commonly relieved using non-steroidal anti-inflammatory drugs, while surgery is required only for those patients with severe pain or in case of failure of previous conservative treatments. Our case report describes a 56-year-old male basketball player who self-referred to our outpatient physical therapy with a shoulder pain complaint. Considering the anamnesis and the physical examination, the physical therapist referred the patient to an orthopaedic surgeon, who suggested a detailed imaging investigation. The peculiarity of this clinical case is the overlapping of two clinical presentations: the symptomatology of the OO and the concurrent mechanical disorder due to a rotator cuff tendinopathy.
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Affiliation(s)
- Filippo Maselli
- Sovrintendenza Sanitaria Regionale Puglia INAIL, 70126 Bari, Italy;
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), Campus of Savona, University of Genova, 17100 Savona, Italy;
| | - Lorenzo Storari
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), Campus of Savona, University of Genova, 17100 Savona, Italy;
- Correspondence:
| | - Mariangela Lorusso
- Department of Clinical Science and Translation Medicine, Faculty of Medicine and Surgery, University of Rome Tor Vergata, 00133 Roma, Italy; (M.L.); (D.P.); (M.S.); (F.B.)
| | - Firas Mourad
- Department of Physiotherapy, LUNEX International University of Health, Exercise and Sports, 4671 Differdange, Luxembourg;
- Luxembourg Health & Sport Sciences Research Institute A.s.b.l., 50, Avenue du Parc des Sports, 4671 Differdange, Luxembourg
| | - Denis Pennella
- Department of Clinical Science and Translation Medicine, Faculty of Medicine and Surgery, University of Rome Tor Vergata, 00133 Roma, Italy; (M.L.); (D.P.); (M.S.); (F.B.)
- Department of Medicine and Health Science “Vincenzo Tiberio”, University of Molise C/da Tappino c/o Cardarelli Hospital, 86100 Campobasso, Italy
| | - Valerio Barbari
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), Campus of Savona, University of Genova, 17100 Savona, Italy;
| | - Mattia Salomon
- Department of Clinical Science and Translation Medicine, Faculty of Medicine and Surgery, University of Rome Tor Vergata, 00133 Roma, Italy; (M.L.); (D.P.); (M.S.); (F.B.)
| | - Fabrizio Brindisino
- Department of Clinical Science and Translation Medicine, Faculty of Medicine and Surgery, University of Rome Tor Vergata, 00133 Roma, Italy; (M.L.); (D.P.); (M.S.); (F.B.)
- Department of Medicine and Health Science “Vincenzo Tiberio”, University of Molise C/da Tappino c/o Cardarelli Hospital, 86100 Campobasso, Italy
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Rajakulendran K, Picardo NE, El-Daly I, Hussein R. Brodie's abscess following percutaneous fixation of distal radius fracture in a child. Strategies Trauma Limb Reconstr 2016; 11:69-73. [PMID: 26984410 PMCID: PMC4814380 DOI: 10.1007/s11751-016-0249-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2014] [Accepted: 02/29/2016] [Indexed: 11/03/2022] Open
Abstract
We report the case of a Brodie's abscess presenting five and a half years following closed reduction and percutaneous pinning of a distal radius fracture. The index surgery was complicated by a pin site infection that was treated successfully with antibiotics. The patient represented with forearm pain years later, and radiological investigations revealed a Brodie's abscess in the distal radius at the site of the previous Kirschner wires. The Brodie's abscess was managed through surgical curettage and antibiotics. Staphylococcus aureus and diphtheroid organisms were cultured from the intraoperative specimens. A Brodie's abscess is a form of localised subacute osteomyelitis, which usually occurs in the metaphysis of long bones and can mimic malignancy. Previous trauma or surgery has been implicated as predisposing factors. We have only identified one previously reported case of Brodie's abscess following percutaneous pinning. Ours is the first reported case in an adolescent. The aim of this paper is to raise awareness of this rare complication and review the current literature.
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Affiliation(s)
- Karthig Rajakulendran
- Basildon and Thurrock University Hospitals NHS Foundation Trust, Nethermayne, Essex, SS16 5NL, UK
| | - Natasha E Picardo
- Basildon and Thurrock University Hospitals NHS Foundation Trust, Nethermayne, Essex, SS16 5NL, UK.
| | - Ibraheim El-Daly
- Basildon and Thurrock University Hospitals NHS Foundation Trust, Nethermayne, Essex, SS16 5NL, UK
| | - Rami Hussein
- Basildon and Thurrock University Hospitals NHS Foundation Trust, Nethermayne, Essex, SS16 5NL, UK
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Zoboski RJ. Occult osteoid osteoma presenting as shoulder pain: a case report. J Chiropr Med 2013; 11:207-14. [PMID: 23450098 DOI: 10.1016/j.jcm.2012.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2011] [Revised: 05/31/2012] [Accepted: 06/26/2012] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE The purpose of this case study is to describe the clinical course and treatment of a patient with recalcitrant shoulder pain and osteoid osteoma. CLINICAL FEATURES A 28-year-old man had a 2-year history of progressively worsening shoulder and midscapular pain. INTERVENTION AND OUTCOME Before chiropractic consultation, he had been evaluated and treated by his family physician, an orthopedic surgeon, a neurologist, and a pain management specialist. The patient underwent arthroscopy with examination under anesthesia and debridement of a posterior labral tear and cervical spine epidural injections, but neither procedure relieved his symptoms. After seeking chiropractic care, presenting symptoms were reproducible during direct clinical examination; and an initial working diagnosis of secondary right glenohumeral impingement syndrome with coexisting scapulothoracic dyskinesis was made. After 2 weeks of chiropractic rehabilitation, therapy was stopped because of no change in symptoms. The patient was referred for orthopedic consultation. Another series of plain films were ordered, and follow-up magnetic resonance imaging revealed an osseous mass at the medial aspect of the proximal metadiaphyseal region of the right humerus, with a diagnosis of osteoid osteoma. The patient underwent radiofrequency thermoablation of the tumor nidus, which was unsuccessful and resulted in open surgical resection. Resolution of symptoms with minimal pain was reported 3 weeks after the surgery. Four years later, the patient's shoulder remains asymptomatic. CONCLUSION This case demonstrates that osteoid osteoma may present with clinical features that mimic common functional musculoskeletal conditions of the shoulder. Information from the patient history and diagnostic imaging are important for diagnosis and appropriate management.
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