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Alruwaii F, Molligan JF, Ilaslan H, John I, Herradura AS, Alkashash A, Chen S, Nystrom L, Kilpatrick SE, Reith JD, Wenger DE, Powell GM, Fritchie KJ. Osteoid osteomas of the hands and feet: a series of 71 cases. Virchows Arch 2023:10.1007/s00428-023-03576-9. [PMID: 37294448 DOI: 10.1007/s00428-023-03576-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 05/28/2023] [Accepted: 05/31/2023] [Indexed: 06/10/2023]
Abstract
Osteoid osteomas typically arise in the long bones of extremities. Patients often report pain relieved by NSAIDS, and radiographic findings are often sufficient for diagnosis. However, when involving the hands/feet, these lesions may go unrecognized or misdiagnosed radiographically due to their small size and prominent reactive changes. The clinicopathologic features of this entity involving the hands and feet are not well-described. Our institutional and consultation archives were searched for all cases of pathologically confirmed osteoid osteomas arising in the hands and feet. Clinical data was obtained and recorded. Seventy-one cases (45 males and 26 females, 7 to 64 years; median 23 years) arose in the hands and feet, representing 12% of institutional and 23% of consultation cases. The clinical impression often included neoplastic and inflammatory etiologies. Radiology studies demonstrated a small lytic lesion in all cases (33/33), the majority of which had a tiny focus of central calcification (26/33). Nearly, all cases demonstrated cortical thickening and/or sclerosis and perilesional edema which almost always had an extent two times greater than the size of the nidus. Histologic examination showed circumscribed osteoblastic lesions with formation of variably mineralized woven bone with single layer of osteoblastic rimming. The most common growth pattern of bone was trabecular (n = 34, 48%) followed by combined trabecular and sheet-like (n = 26, 37%) with only 11 (15%) cases presenting with pure sheet-like growth pattern. The majority (n = 57, 80%) showed intra-trabecular vascular stroma. No case showed significant cytology atypia. Follow up was available for 48 cases (1-432 months), and 4 cases recurred. Osteoid osteomas involving the hands and feet follow a similar age and sex distribution as their non-acral counterparts. These lesions often present with a broad differential diagnosis and may initially be confused with chronic osteomyelitis or a reactive process. While the majority of cases have classic morphologic features on histologic exam, a small subset consists solely of sheet-like sclerotic bone. Awareness that this entity may present in the hands and feet will help pathologists, radiologists, and clinicians accurately diagnose these tumors.
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Affiliation(s)
- Fatimah Alruwaii
- Department of Anatomic Pathology, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA
| | - Jeremiah F Molligan
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Hakan Ilaslan
- Department of Radiology, Cleveland Clinic, Cleveland, OH, USA
| | - Ivy John
- Department of Pathology, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Ahmad Alkashash
- Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, IN, USA
| | - Shaoxiong Chen
- Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, IN, USA
| | - Lukas Nystrom
- Department of Orthopedic Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Scott E Kilpatrick
- Department of Anatomic Pathology, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA
| | - John D Reith
- Department of Anatomic Pathology, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA
| | - Doris E Wenger
- Department of Diagnostic Radiology, Mayo Clinic, Rochester, MN, USA
| | - Garret M Powell
- Department of Diagnostic Radiology, Mayo Clinic, Rochester, MN, USA
| | - Karen J Fritchie
- Department of Anatomic Pathology, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
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Vita F, Tuzzato G, Pederiva D, Bianchi G, Marcuzzi A, Adani R, Spinnato P, Miceli M, Donati D, Manzetti M, Pilla F, Faldini C. Osteoid Osteoma of the Hand: Surgical Treatment versus CT-Guided Percutaneous Radiofrequency Thermal Ablation. Life (Basel) 2023; 13:1351. [PMID: 37374133 DOI: 10.3390/life13061351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 06/05/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
(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.
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Affiliation(s)
- Fabio Vita
- IRCCS-Rizzoli Orthopedic Institute, University of Bologna, 40136 Bologna, Italy
| | - Gianmarco Tuzzato
- IRCCS-Rizzoli Orthopedic Institute, University of Bologna, 40136 Bologna, Italy
| | - Davide Pederiva
- IRCCS-Rizzoli Orthopedic Institute, University of Bologna, 40136 Bologna, Italy
| | - Giuseppe Bianchi
- IRCCS-Rizzoli Orthopedic Institute, University of Bologna, 40136 Bologna, Italy
| | - Augusto Marcuzzi
- Department of Hand Surgery and Microsurgery, University Hospital of Modena, 41124 Modena, Italy
| | - Roberto Adani
- Department of Hand Surgery and Microsurgery, University Hospital of Modena, 41124 Modena, Italy
| | - Paolo Spinnato
- IRCCS-Rizzoli Orthopedic Institute, University of Bologna, 40136 Bologna, Italy
| | - Marco Miceli
- IRCCS-Rizzoli Orthopedic Institute, University of Bologna, 40136 Bologna, Italy
| | - Danilo Donati
- Department of Hand Surgery and Microsurgery, University Hospital of Modena, 41124 Modena, Italy
| | - Marco Manzetti
- IRCCS-Rizzoli Orthopedic Institute, University of Bologna, 40136 Bologna, Italy
| | - Federico Pilla
- IRCCS-Rizzoli Orthopedic Institute, University of Bologna, 40136 Bologna, Italy
| | - Cesare Faldini
- IRCCS-Rizzoli Orthopedic Institute, University of Bologna, 40136 Bologna, Italy
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Singh DK, Katyan A, Kumar N, Nigam K, Jaiswal B, Misra RN. CT-guided radiofrequency ablation of osteoid osteoma: established concepts and new ideas. Br J Radiol 2020; 93:20200266. [PMID: 32520586 DOI: 10.1259/bjr.20200266] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Osteoid osteoma is a painful benign bone tumour of children and young adults with characteristic clinico-radiological features depending upon the location of the lesion. Intraoperative visualisation of the nidus is difficult and therefore curative surgery is often associated with excessive bone removal, significant perioperative morbidity and potential need of bone grafting procedures. With advancement in cross-sectional imaging and radiofrequency ablation (RFA) technology, CT-guided RFA has emerged as the treatment of choice for the osteoid osteoma. This procedure involves accurate cannulation of the nidus and subsequent thermocoagulation-induced necrosis.Multidisciplinary management approach is the standard of care for patients with osteoid osteoma. Appropriate patient selection, identification of imaging pitfalls, pre-anaesthetic evaluation and a protocol-based interventional approach are the cornerstone for a favourable outcome. Comprehensive patient preparation with proper patient position and insulation is important to prevent complications. Use of spinal needle-guided placement of introducer needle, namely, "rail-road technique" is associated with fewer needle trajectory modifications, reduced radiation dose and patient morbidity and less intervention time. Certain other procedural modifications are employed in special situations, for example, intra-articular osteoid osteoma and osteoid osteoma of the subcutaneous bone in order to reduce complications. Treatment follow-up generally includes radiographic assessment and evaluation of pain score. Dynamic contrast-enhanced MRI has been recently found useful for demonstrating post-RFA healing.
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Affiliation(s)
- Dharmendra Kumar Singh
- Department of Radiology and Imaging, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Amit Katyan
- Department of Radiology and Imaging, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Nishith Kumar
- Department of Radiology and Imaging, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Kanchan Nigam
- Department of Radiology and Imaging, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Binita Jaiswal
- Department of Anesthesia and Critical Care, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Ritu Nair Misra
- Department of Radiology and Imaging, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
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Michaelides M, Drakonaki E, Petridou E, Pantziara M, Ioannides C. Osteoid osteoma of the scaphoid bone associated with flexor carpi radialis calcific tendinitis and treated with CT-guided RF ablation. Skeletal Radiol 2018. [PMID: 29541786 DOI: 10.1007/s00256-018-2926-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Osteoid osteomas of the wrist are relatively rare and the diagnosis is challenging due to atypical clinical features. We describe a case of an osteoid osteoma of the scaphoid bone associated with calcific tendinitis of the adjacent flexor carpi radialis tendon and periarticular soft tissue calcifications in a 21-year-old man presenting with radial-sided wrist pain. The lesion was successfully treated with CT-guided RF ablation. To our knowledge, this is the first description of an osteoid osteoma of the wrist associated with calcific tendinitis and periarthritis. In addition, we discuss the technical details and difficulties of CT-guided RF ablation of scaphoid osteoid osteomas.
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Affiliation(s)
- Michalis Michaelides
- MRI/CT Department, Ygia Polyclinic Hospital, 21 Nafpliou str., PO Box 56174, 3305, Limassol, Cyprus.
| | | | - Elia Petridou
- MRI/CT Department, Ygia Polyclinic Hospital, 21 Nafpliou str., PO Box 56174, 3305, Limassol, Cyprus
| | - Maria Pantziara
- MRI/CT Department, Ygia Polyclinic Hospital, 21 Nafpliou str., PO Box 56174, 3305, Limassol, Cyprus
| | - Cleanthis Ioannides
- MRI/CT Department, Ygia Polyclinic Hospital, 21 Nafpliou str., PO Box 56174, 3305, Limassol, Cyprus
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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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Tumors of the hand. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 2017; 27:747-762. [DOI: 10.1007/s00590-017-1984-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Accepted: 05/30/2017] [Indexed: 12/15/2022]
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Imaging Diagnosis of Solitary Tumors of the Phalanges and Metacarpals of the Hand. AJR Am J Roentgenol 2015; 205:106-15. [PMID: 26102388 DOI: 10.2214/ajr.14.13340] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Tumors and tumorlike lesions of the tubular bones of the hand, often incidentally discovered lesions, present a unique but challenging differential diagnosis. CONCLUSION Imaging, including both radiography and cross-sectional imaging, can allow the radiologist to generate a clinically useful differential diagnosis based on the distinguishing features of these entities. Recognition of these lesions is important because clinical management and treatment by orthopedic oncologists vary depending on the diagnosis.
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Osteoid osteoma of distal phalanx of toe: a rare cause of foot pain. Case Rep Orthop 2014; 2014:560892. [PMID: 25328736 PMCID: PMC4190831 DOI: 10.1155/2014/560892] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2014] [Revised: 09/02/2014] [Accepted: 09/03/2014] [Indexed: 11/18/2022] Open
Abstract
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 toe is very rare and arising in a pedal phalanx may be difficult to diagnose. A 34-year-old male has local swelling and tenderness but there were no hyperemia, temperature increase, or clubbing. There was a 2-month history of antibiotic treatment with suspicion of soft tissue infection in another clinic. The osteoid osteoma was completely excised by curettage and nidus removal with open surgical technique. The patient was followed up for 63 months with annual clinical and radiographic evaluations. There was no relapse of the pain and no residual recurrent tumour. Osteoid osteoma may be difficult to distinguish from chronic infection or myxedema. The patients may be taken for unnecessary treatment. 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. Osteoid osteomas having radiologic and clinical features other than classical presentation of osteoid osteoma are called atypical osteoid osteomas. Atypical localized osteoid osteomas can be easily misdiagnosed and treatment is often complicated.
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9
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Osteoid osteoma of the phalanx and metacarpal bone: report of 17 cases. Musculoskelet Surg 2014; 99:61-5. [PMID: 25132395 DOI: 10.1007/s12306-014-0337-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Accepted: 08/04/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Osteoid osteoma (OO) is a slowly progressing benign osteoblastic tumour. In the hand, this tumour is rare. We propose a review of seventeen cases of OO of the phalanx and metacarpal bone. PATIENTS AND METHODS During the period, between 1998 and 2011, a total of seventeen OO in the hand were confirmed by the pathological examination. They were 10 women and 7 men with an average age of 29 years (age range 17-76). The most common site of the tumour was the proximal phalanx in ten cases, followed by middle phalanx in four cases and metacarpal bone in three cases. The diagnosis of OO was highly required by clinical history. Standard radiographs showed variable images, but computed tomography, and it was useful to facilitate diagnosis and pre-operative planning. All patients underwent surgery (the tumour resection and autogenous bone grafting). In post-operative, there was an immediate pain relief with complete resolution of all symptoms. No recurrence was observed during the last follow-up period of 4 years and 2 months. CONCLUSION The diagnosis of OO of the hand can be difficult, and it should be considered with bony pain or bony swelling, especially when the history is a chronic one. The CT scan allows visualisation and precise localisation of such benign tumour of the hand. The care should be taken to make the excision complete in order to avoid recurrence.
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11
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Rosenthal D, Callstrom MR. Critical Review and State of the Art in Interventional Oncology: Benign and Metastatic Disease Involving Bone. Radiology 2012; 262:765-80. [DOI: 10.1148/radiol.11101384] [Citation(s) in RCA: 108] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Galdi B, Capo JT, Nourbakhsh A, Patterson F. Osteoid osteoma of the thumb: a case report. Hand (N Y) 2010; 5:423-6. [PMID: 22131926 PMCID: PMC2988130 DOI: 10.1007/s11552-010-9257-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2009] [Accepted: 01/14/2010] [Indexed: 01/08/2023]
Abstract
Osteoid osteoma is a rare occurrence in the hand, and only a small percentage affects the thumb and distal phalanges. An 18-year-old right-hand-dominant man presented to our office with an approximately 1-year history of left thumb pain without any history of trauma. He had seen several doctors previously and undergone multiple diagnostic tests with no definitive diagnosis. Plain radiographs and computed tomography at our institution were consistent with the diagnosis of osteoid osteoma. The patient was treated with surgical excision of the lesion without bone grafting. The diagnosis of osteoid osteoma was confirmed by pathology. At 6 months follow-up, the patient showed complete resolution of pain and full restoration of hand function. This case demonstrates that osteoid osteoma should not be forgotten as a differential diagnosis in patients with finger pain, especially in individuals who have not yet or just recently have reached skeletal maturity.
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Affiliation(s)
- Balazs Galdi
- Orthopedics Department, UMDNJ—New Jersey Medical School, 90 Bergen Street, DOC 1200, Newark, NJ 07103 USA
| | - John T. Capo
- Orthopedics Department, UMDNJ—New Jersey Medical School, 90 Bergen Street, DOC 1200, Newark, NJ 07103 USA
| | - Ali Nourbakhsh
- Orthopedics Department, UMDNJ—New Jersey Medical School, 90 Bergen Street, DOC 1200, Newark, NJ 07103 USA
| | - Francis Patterson
- Orthopedics Department, UMDNJ—New Jersey Medical School, 90 Bergen Street, DOC 1200, Newark, NJ 07103 USA
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Payne WT, Merrell G. Benign bony and soft tissue tumors of the hand. J Hand Surg Am 2010; 35:1901-10. [PMID: 20961700 DOI: 10.1016/j.jhsa.2010.08.015] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2010] [Accepted: 08/16/2010] [Indexed: 02/02/2023]
Abstract
It is important to be familiar with the wide variety of benign tumors that may present in everyday hand surgery practice. The treatment of many of these tumors in the hand is based on studies with small numbers of patients or the treatment of similar lesions elsewhere in the body. The purpose of this review is to summarize the recent literature relevant to benign bony and soft tissue tumors in the hand.
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Affiliation(s)
- William T Payne
- University of Colorado Denver, Aurora, CO; and Indiana Hand Center, Indianapolis, IN 46260, USA
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Akhlaghpoor S, Aziz Ahari A, Arjmand Shabestari A, Alinaghizadeh MR. Radiofrequency ablation of osteoid osteoma in atypical locations: a case series. Clin Orthop Relat Res 2010; 468:1963-70. [PMID: 20174900 PMCID: PMC2882005 DOI: 10.1007/s11999-010-1265-0] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2009] [Accepted: 02/02/2010] [Indexed: 02/06/2023]
Abstract
BACKGROUND Osteoid osteoma has a nidus surrounded by sclerotic bone with a size usually less than 20 mm. Its diagnosis is made on typical presentation of nocturnal pain and imaging findings. Excision of the niduses, which are often small and difficult to precisely identify, sometimes may result in resection of surrounding normal bone. Minimally invasive percutaneous treatments have been used to try to minimize resection of normal bone. Although minimally invasive radiofrequency ablation generally relieves pain, its ability to relieve pain is less well known in locations other than lower extremity long bones. QUESTIONS/PURPOSES We determined the pain relief and complication rates after radiofrequency ablation of osteoid osteomas presenting in atypical locations and followed patients to assess possible recurrence or late complications. PATIENTS AND METHODS We retrospectively reviewed 21 patients with osteoid osteomas in unusual locations (eg, hip, radioulnar joint, and proximal phalanx) in whom we used radiofrequency ablation. Postoperative activities were not restricted for any of the patients. We assessed the time for patients to become symptom free, their activity status, and possible recurrence or complications. The minimum clinical followup was 12 months (mean, 27.8 months; range, 12-37 months). RESULTS All patients became symptom free within 24 hours to 1 week. During followup, none of the patients experienced recurrence or any major complications. CONCLUSIONS Radiofrequency ablation for osteoid osteomas in unusual locations reliably relieves pain with few complications and recurrences at short-term followup. LEVEL OF EVIDENCE Level IV, case series. See Guidelines for Authors for a complete description of level of evidence.
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Affiliation(s)
- Shahram Akhlaghpoor
- Noor Medical Imaging Center, Shahid Yousefian St, Motahari St, Tehran, Iran.
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Affiliation(s)
- Eugene T H Ek
- Orthopaedic Unit, Bendigo Hospital, Victoria, Australia
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Harrod CC, Boykin RE, Jupiter JB. Pain and swelling after radiofrequency treatment of proximal phalanx osteoid osteoma: case report. J Hand Surg Am 2010; 35:990-4. [PMID: 20452144 DOI: 10.1016/j.jhsa.2010.03.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2009] [Revised: 03/03/2010] [Accepted: 03/05/2010] [Indexed: 02/02/2023]
Abstract
Bony tumors in the hand and wrist are uncommon conditions. The objective of this article was to describe an impressive soft-tissue reaction with pain after radiofrequency ablation was used to treat a proximal phalangeal osteoid osteoma in the hand. We feel radiofrequency ablation should be cautiously used in the treatment of these lesions out of concern for similar complications.
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Affiliation(s)
- Christopher C Harrod
- Orthopaedic Associates, Massachusetts General Hospital, Boston, MA 02114-2696, USA
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Di Gennaro GL, Lampasi M, Bosco A, Donzelli O. Osteoid osteoma of the distal thumb phalanx: a case report. ACTA ACUST UNITED AC 2008; 92:179-82. [PMID: 19052928 DOI: 10.1007/s12306-008-0061-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2008] [Accepted: 09/17/2008] [Indexed: 10/21/2022]
Abstract
Osteoid osteomas of the hand are uncommon. Particularly, location in the thumb and involvement of the distal phalanx are very rarely reported. Long diagnostic delay and inadequate treatment are typical, since clinical features may mimic other causes more frequently found in the same site (post-traumatic, infective, rheumatic, neoplastic conditions, regional pain syndrome) and even the nail morphology may be altered, as in the reported case (watch-glass deformity). A case of an osteoid osteoma of the distal thumb phalanx in a 27-year-old man is presented, along with its clinical, radiographic and CT findings. In the Authors' opinion, curettage should be considered the treatment of choice.
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Affiliation(s)
- Giovanni Luigi Di Gennaro
- Department of Paediatric Orthopaedics and Traumatology, Rizzoli Orthopaedic Institute, Via Pupilli 1, Bologna, Italy
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19
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Zouari L, Bousson V, Hamzé B, Roulot E, Roqueplan F, Laredo JD. CT-guided percutaneous laser photocoagulation of osteoid osteomas of the hands and feet. Eur Radiol 2008; 18:2635-41. [DOI: 10.1007/s00330-008-1045-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2007] [Revised: 03/29/2008] [Accepted: 04/19/2008] [Indexed: 02/06/2023]
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Hedrich CM, Fiebig B, Sallmann S, Bruck N, Thielemann F, Hahn G, Heubner G, Gahr M. [Osteoid osteomas of the fingers: an atypical localization? Two case reports and a review of the literature]. Z Rheumatol 2008; 67:145-8, 150. [PMID: 18309500 DOI: 10.1007/s00393-008-0262-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Osteoid osteomas are painful bone tumors that usually occur in childhood or adolescence. Despite the small size of the bony lesions osteoid osteomas can cause persistent pain. Pathogenesis has not been completely understood. Remission usually occurs within several months to years. Therefore surgical therapy is not indicated in all cases. Nevertheless, as a result of reduced quality of life due to pain, sufficient analgesic/antiinflammatory therapy needs to be provided. We report on two male patients, aged 10 and 14 years, who presented with arthritis of the finger joints. As a result of both patients' histories, and following radiographic imaging and magnetic resonance imaging, a diagnosis of osteoid osteoma was made. Remission could be achieved in both patients following treatment with nonsteroidal antiinflammatory drugs (NSAIDs).In addition to the typical sites at the long bones of the lower extremity, osteoid osteomas can also localize to other sites such as fingers. In the case of definitive diagnosis and under close follow-up, medical treatment with NSAIDs is an alternative to surgical strategies. The operative risk should be weighed against the risk of long-term treatment with NSAIDs.
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Affiliation(s)
- C M Hedrich
- Arbeitsbereich Pädiatrische Rheumatologie und Immunologie, Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Deutschland.
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Sofka CM, Saboeiro GR, Schneider R. Magnetic resonance imaging diagnosis and computed tomography-guided radiofrequency ablation of osteoid osteoma. HSS J 2006; 2:55-8. [PMID: 18751847 PMCID: PMC2504116 DOI: 10.1007/s11420-005-0140-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Carolyn M. Sofka
- Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY USA ,Weill Medical College of Cornell University, 535 East 70th Street, New York, NY USA
| | - Gregory R. Saboeiro
- Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY USA
| | - Robert Schneider
- Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY USA
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