Arthroscopic removal of an intra-articular osteoid osteoma of the radial styloid

Arthroscopic management of intra- and juxta-articular osteoid osteoma of the upper extremity: a systematic review of the literature

BACKGROUND

Intra- and juxta-articular osteoid osteoma (OO) is rare and can result in irreversible joint damage. Recently, arthroscopic surgery is being used more and more to avoid complications associated with other treatment modalities.

METHODS

On October 13, 2019, we conducted a systematic review of the literature available in PubMed and EMBASE regarding the arthroscopic management of OO involving the joints of the upper extremity. Predetermined inclusion criteria were used to include any relevant article published on and before that date for further analysis. Treatment success rate and tumor recurrence rate were considered the primary outcomes in our analysis.

RESULTS

Out of 113 studies, 19 met our inclusion criteria. Of the 32 reported cases in these 19 articles, ten involved the shoulder joint, 19 involved the elbow joint and three involved the wrist joint. Overall treatment success rate was 93.8%. Tumor recurrence rate was 0.0%. No postoperative complications (0.0%) were reported among cases involving the shoulder joint. Two out of 24 (8.3%) patients with elbow OO failed arthroscopic treatment due to incomplete excision, and two (4%) experienced minor complications. Among the three cases of wrist OO, two (66.7%) patients had residual postoperative pain and decreased hand grip strength.

CONCLUSION

Arthroscopic management of OO of the upper extremity joints is highly successful and results in no tumor recurrence; however, there is a risk of incomplete resection in areas more difficult to access by arthroscopy.

Osteoid Osteoma of the Radial Styloid Resembling de Quervain's Disease

We describe a case of osteoid osteoma in the radial styloid of a 37-year old man mimicking de Quervain's disease. The exact diagnosis was made with CT examination and confirmed by histological evaluation of the tumour. The lesion was removed by curettage and symptoms were resolved rapidly thereafter. There was no sign of recurrence at one year follow-up.

Hip arthroscopy for the management of osteoid osteoma of the acetabulum: a systematic review of the literature and case report

Background

Intra-articular osteoid osteoma (OO) causes irreversible joint damage. Its treatment of choice is radiofrequency ablation (RFA); however, some areas of the acetabulum are hard to access. Therefore, hip arthroscopy was used to treat this tumor. We aim to systematically review the literature with regards to arthroscopic management of acetabular OO, and to report a further case in which hip arthroscopy was used for treatment.

Methods

PubMed and EMBASE were searched for articles relevant to the arthroscopic management of acetabular OO on December 2, 2014. All articles published on and before that date were reviewed, and studies which met our pre-determined inclusion criteria were included. Articles screening and data abstraction were done by two reviewers independently. We also presented a 31-year-old man with acetabular OO who underwent hip arthroscopy for the management of his tumor after failing to respond to medications and computed tomography scan (CT)-guided RFA.

Results

The initial search revealed 14 studies, of which ten met our inclusion criteria. A total of ten patients underwent hip arthroscopy for the management of acetabular OO. Only two patients were females, and the patients' age ranged from 7 to 47 years. Two patients underwent arthroscopic guided-RFA of the lesion, while the rest underwent excision. The follow-up period ranged from 6 months to 2 years. Success rate was 100 %, and no recurrence was reported. Minor complications (transient impotence and perineal numbness) developed in one patient (10 %). Arthroscopic-guided RFA failed to eliminate the tumor in our additional case. A second trial of CT-guided RFA was successful in treating the patient's condition.

Conclusions

Hip arthroscopy is an effective and safe option for the management of acetabular OO, with success rate exceeding 90 %. Studies of higher level of evidence are required.

Electronic supplementary material

The online version of this article (doi:10.1186/s12891-015-0779-8) contains supplementary material, which is available to authorized users.

Osteoid osteoma

Osteoid osteomas consist of a nidus with surrounding sclerotic bone. The differential diagnosis covers a wide range of conditions due to the variable presentation of osteoid osteoma. The natural history is for regression to occur within 6 to 15 years with no treatment; however, this can be reduced to 2 to 3 years with the use of aspirin and non-steroidal anti-inflammatory drugs. Computed tomography-guided percutaneous techniques, including trephine excision, cryoablation, radiofrequency ablation, and laser thermocoagulation, are described.