1
|
Jamshidi K, Toloue Ghamari B, Mokhles P, Mohammadi Aniloo F. Multifocal Bizarre Parosteal Osteocartilaginous Proliferation of the Foot: A Case Report. JBJS Case Connect 2024; 14:01709767-202409000-00001. [PMID: 38968366 DOI: 10.2106/jbjs.cc.23.00678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/07/2024]
Abstract
CASE Bizarre parosteal osteocartilaginous proliferation (BPOP) is rare, especially in the foot. To the best of our knowledge, multifocal BPOP has yet to be reported. We are reporting a case of a 40-year-old woman who presented with 4 bumps over her midfoot and toes. After staging studies, we excised the lesions, and histopathology confirmed BPOP. No local recurrence was observed at the end of the 2-year follow-up. CONCLUSION BPOP should be considered in the differential diagnosis of multiple foot bumps, whether synchronous or metachronous, which may present multifocally in the foot.
Collapse
Affiliation(s)
- Khodamorad Jamshidi
- Department of Orthopedics, School of Medicine, Bone and Joint Reconstruction Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Babak Toloue Ghamari
- Department of Orthopedics, School of Medicine, Bone and Joint Reconstruction Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Parisa Mokhles
- Iran University of Medical Sciences, School of Medicine, Tehran, Iran
| | | |
Collapse
|
2
|
Saad A, Iyengar KP, Kurisunkal VJ, Nischal N, Davies A, Botchu R. Periostitis Ossificans: Largest Case Series with Review of Literature. Indian J Radiol Imaging 2024; 34:32-36. [PMID: 38106865 PMCID: PMC10723957 DOI: 10.1055/s-0043-1770723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023] Open
Abstract
Background Periostitis ossificans (PO) are rare, benign ossifying surface lesions characterized by the centripetal ossification with osseous and soft-tissue edema. Their clinicoradiological appearances can easily mimic those of more sinister or infective surface lesion. Objective This study aimed to explore the various anatomical locations and muscle attachment at the site of PO, and evaluate the role of complementary image findings in patients presenting at our tertiary orthopaedic referral center. Patients and Methods A retrospective review of our oncology and radiology databases was undertaken to identify patients with PO reported on radiographs, magnetic resonance imaging (MRI) and computed tomography (CT) over the past 13 years (2007-2020). Patient demographics, sites of PO, muscle attachment at the site of PO, findings on complementary imaging, and clinical management outcome were documented. Results We identified 38 patients with PO with a mean age of 24 years (range: 4-66 years). Muscle attachment was seen at the site of PO in the majority of cases (89%). The majority of PO were in the lower limb and commonly seen around the attachment of quadriceps. Deltoid attachment was commonly involved in the upper limb. Conclusion Muscle attachment is commonly seen at the site of PO, which results in stripping of the periosteum resulting in soft-tissue and osseous edema and centripetal ossification.
Collapse
Affiliation(s)
- Ahmed Saad
- Department of Orthopedic Oncology, Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, United Kingdom
| | - Karthikeyan P. Iyengar
- Department of Orthopedics, Southport and Ormskirk Hospital NHS Trust, Southport, United Kingdom
| | - Vineet John Kurisunkal
- Department of Orthopedic Oncology, Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, United Kingdom
| | - Neha Nischal
- Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, United Kingdom
| | - A.M. Davies
- Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, United Kingdom
| | - Rajesh Botchu
- Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, United Kingdom
| |
Collapse
|
3
|
Tang J, Wang X, Liu E, Niu Z, Zuo J, Liu T, Li H. Florid reactive periostitis of the clavicle: A case report and literature review. Medicine (Baltimore) 2023; 102:e36674. [PMID: 38115327 PMCID: PMC10727642 DOI: 10.1097/md.0000000000036674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 11/24/2023] [Indexed: 12/21/2023] Open
Abstract
RATIONALE Florid reactive periostitis (FRP), a rare reactive bone lesion, typically presents in the short tubular bones of the extremities, with infrequent occurrences in the long tubular bones. This report discusses a unique case of FRP in the clavicle, managed through comprehensive lesion debridement and bone grafting, yielding positive results over a 3-year duration. PATIENT CONCERN A 25-year-old male presented with a discernible mass at the left sternal end of the clavicle, discovered incidentally 2 weeks prior. The patient exhibited no clinical signs of inflammation, pain, sinus tract, or suppuration. DIAGNOSIS Initial pathological examination of the local excision suggested benign lesions, although malignancy could not be ruled out. A definitive diagnosis of clavicular FRP was reached post complete lesion resection, with supporting evidence from postoperative pathology, imaging, and clinical symptoms. INTERVENTION The left clavicle was reconstructed through an open surgical procedure involving total mass removal and ipsilateral extraction of an iliac bone of suitable dimensions. This was implanted into the clavicular bone defect and internally fixed with a plate. OUTCOMES Three years of consecutive follow-up revealed no recurrence of hyperplasia, absence of mass or tenderness at the left sternal end of the clavicle, and unimpaired function of adjacent joints. LESSONS The primary clinical challenge with FRP is its diagnosis. While pathological diagnosis remains crucial, it is also important to incorporate imaging and clinical symptoms for a comprehensive assessment. Complete mass excision may offer specific benefits in distinguishing FRP from its malignant counterparts.
Collapse
Affiliation(s)
- Jinshuo Tang
- Department of Orthopaedics, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
| | - Xuemei Wang
- Department of Pathology, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
| | - Enbo Liu
- Department of Orthopaedics, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
| | - Zhixin Niu
- Department of Orthopaedics, Jiaozuo People’s Hospital, Jiaozuo, Henan, China
| | - Jianlin Zuo
- Department of Orthopaedics, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
| | - Tong Liu
- Department of Orthopaedics, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
| | - Hongwei Li
- Department of Orthopaedics, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
| |
Collapse
|
4
|
Test Yourself Answer To Question: A 44-year-old Female Presented with a 12-month History of Elbow Pain. Skeletal Radiol 2022; 51:2233-2234. [PMID: 35347407 DOI: 10.1007/s00256-022-04039-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/16/2022] [Accepted: 03/17/2022] [Indexed: 02/02/2023]
|
5
|
Kim MS, Bolia IK, Iglesias B, Sharf T, Roberts SI, Kang H, Christ AB, Menendez LR. Timing of treatment in osteosarcoma: challenges and perspectives - a scoping review. BMC Cancer 2022; 22:970. [PMID: 36088295 PMCID: PMC9464396 DOI: 10.1186/s12885-022-10061-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 09/05/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The timing of events in the management of osteosarcoma may be critical for patient survivorship; however, the prognostic value of factors such as onset of symptoms or initiation of therapy in these patients has not been studied. This study sought to review the literature reporting treatment of osteosarcoma to determine the utility of event timing as a prognostic indicator. Due to significant heterogeneity in the literature, this study was conducted as a scoping review to assess the current state of the literature, identify strengths and weaknesses in current reporting practices, and to propose avenues for future improvement. MAIN BODY This review screened 312 peer-reviewed studies of osteosarcoma in any anatomic location published in an English journal for reporting of an event timing metric of any kind in a population of 6 or more. Thirty-seven studies met inclusion/exclusion criteria and were assessed for level of evidence, quality, and event timing metric. Reviewers also collated: publication year, population size, population age, tumor site, tumor type, surgical treatment, and adjuvant medical treatment. Extracted event timing data were further characterized using nine standardized categories to enable systematic analysis. The reporting of event timing in the treatment of osteosarcoma was incomplete and heterogenous. Only 37 of 312 (11.9%) screened studies reported event timing in any capacity. The period between patient-reported symptom initiation and definitive diagnosis was the most reported (17/37, 45.9%). Symptom duration was the second most reported period (10/37, 27.0%). Event timing was typically reported incidentally and was never rigorously incorporated into data analysis or discussion. No studies considered the impact of event timing on a primary outcome. The six largest studies were assessed in detail to identify pearls for future researchers. Notable shortcomings included the inadequate reporting of the definition of an event timing period and the pooling of patients into poorly defined timing groups. CONCLUSIONS Inconsistent reporting of event timing in osteosarcoma treatment prevents the development of clinically useful conclusions despite evidence to suggest event timing is a useful prognostic indicator. Consensus guidelines are necessary to improve uniformity and utility in the reporting of event timing.
Collapse
Affiliation(s)
- Michael S Kim
- Department of Orthopaedic Surgery, Keck School of Medicine of USC, 1520 San Pablo St, HC2 #2000, Los Angeles, CA, 90033, USA
| | - Ioanna K Bolia
- Department of Orthopaedic Surgery, Keck School of Medicine of USC, 1520 San Pablo St, HC2 #2000, Los Angeles, CA, 90033, USA
| | - Brenda Iglesias
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Tamara Sharf
- Department of Orthopaedic Surgery, Keck School of Medicine of USC, 1520 San Pablo St, HC2 #2000, Los Angeles, CA, 90033, USA
| | - Sidney I Roberts
- Department of Orthopaedic Surgery, Keck School of Medicine of USC, 1520 San Pablo St, HC2 #2000, Los Angeles, CA, 90033, USA
| | - Hyunwoo Kang
- Department of Orthopaedic Surgery, Keck School of Medicine of USC, 1520 San Pablo St, HC2 #2000, Los Angeles, CA, 90033, USA
| | - Alexander B Christ
- Department of Orthopaedic Surgery, Keck School of Medicine of USC, 1520 San Pablo St, HC2 #2000, Los Angeles, CA, 90033, USA.
| | - Lawrence R Menendez
- Department of Orthopaedic Surgery, Keck School of Medicine of USC, 1520 San Pablo St, HC2 #2000, Los Angeles, CA, 90033, USA
| |
Collapse
|
6
|
Park HE, Chai JW, Jo CH, Kim JE, Kim DH, Kim HJ, Seo J. Florid Reactive Periostitis of the Clavicle: A Case Report. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2022; 83:414-419. [PMID: 36237924 PMCID: PMC9514431 DOI: 10.3348/jksr.2021.0108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 08/11/2021] [Accepted: 10/18/2021] [Indexed: 11/15/2022]
Abstract
Florid reactive periostitis (FRP) is a rare benign fibro-osseous proliferation, occurring mostly in the short tubular bones of hands and rarely in the long tubular bones. We report a surgically confirmed case of FRP involving the clavicle in a 26-year-old male. On MRI scans, a soft tissue mass with T2 high signal intensity was found that originated from the periosteum of the clavicle and included surrounding a periosteal elevation and perilesional soft tissue edema. Strong contrast enhancement was noted inside the mass and along the periosteum involving more than half of the circumference of the clavicle. Serial radiographs revealed a soft tissue mass without mineralization that turned into an ossified mass with a solid periosteal reaction within a month.
Collapse
Affiliation(s)
- Hye Eun Park
- Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
- Department of Pathology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
| | - Jee Won Chai
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
- Department of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
| | - Chris Hyunchul Jo
- Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea
- Department of Orthopedic Surgery, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
| | - Ji Eun Kim
- Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
- Department of Pathology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
| | - Dong Hyun Kim
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
- Department of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
| | - Hyo Jin Kim
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
- Department of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
| | - Jiwoon Seo
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
- Department of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
| |
Collapse
|
7
|
Levy JL, Louka KL, Cooper K, Weber KL, Dianat S. Focal reactive periostitis ossificans in a long bone: radiologic and pathologic findings. Radiol Case Rep 2021; 16:3638-3642. [PMID: 34630790 PMCID: PMC8495033 DOI: 10.1016/j.radcr.2021.09.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 09/04/2021] [Accepted: 09/04/2021] [Indexed: 11/22/2022] Open
Abstract
Florid reactive periostitis ossificans (FRPO) is a benign juxta-cortical lesion of unknown etiology which most commonly occurs in the hands and feet. We report the radiographic, CT, and MR features of a pathologically confirmed FRPO in the distal femur, a location in which only a handful of cases has been reported. A 26-year-old male who presented with distal thigh pain initially underwent radiograph and CT, which illustrated a well-circumscribed, ossified lesion associated with the cortex of the femur without contiguity with the medullary canal. A subsequent MRI demonstrated heterogeneous signal intensity corresponding to the ossified portion of the lesion with a T2 hyperintense cartilaginous cap and surrounding edema. The lesion was surgically excised and pathologic diagnosis of FRPO, a mixture of osteoid, mature bone, cartilage and fibrous tissue, with associated inflammatory cells, was confirmed. Follow up four months after surgery revealed significant improvement in the patient's pain.
Collapse
Affiliation(s)
- Jennifer L Levy
- Division of Musculoskeletal Radiology, Department of Radiology, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, USA 19104
| | - Katie L Louka
- Division of Bone and Soft Tissue Pathology, Department of Pathology, University of Pennsylvania, Philadelphia, PA, USA
| | - Kumarasen Cooper
- Division of Bone and Soft Tissue Pathology, Department of Pathology, University of Pennsylvania, Philadelphia, PA, USA
| | - Kristy L Weber
- Division of Orthopedic Oncology, Department of Orthopedics, University of Pennsylvania, Philadelphia, PA, USA
| | - Saeed Dianat
- Division of Musculoskeletal Radiology, Department of Radiology, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, USA 19104
- Corresponding author.
| |
Collapse
|
8
|
Mirioğlu A, Bağir M, Bozkurt O, Erdoğan KE. A rare clinical entity: Florid reactive periostitis. Case report and literature review. HAND SURGERY & REHABILITATION 2021; 40:702-703. [PMID: 33971292 DOI: 10.1016/j.hansur.2021.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 04/23/2021] [Accepted: 05/03/2021] [Indexed: 11/18/2022]
Affiliation(s)
- A Mirioğlu
- Department of Orthopedics and Traumatology, Cukurova University Faculty of Medicine, 01330 Sariçam-Adana, Turkey.
| | - M Bağir
- Department of Orthopedics and Traumatology, Cukurova University Faculty of Medicine, 01330 Sariçam-Adana, Turkey.
| | - O Bozkurt
- Department of Orthopedics and Traumatology, Cukurova University Faculty of Medicine, 01330 Sariçam-Adana, Turkey.
| | - K E Erdoğan
- Department of Pathology, Cukurova University Faculty of Medicine, 01330 Sariçam-Adana, Turkey.
| |
Collapse
|
9
|
Memon RA, Wei S, Siegal GP. Some Reactive Lesions of Bone Are Probably Neoplasms: A Review. Arch Pathol Lab Med 2021; 146:60-69. [PMID: 33946096 DOI: 10.5858/arpa.2020-0817-ra] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2021] [Indexed: 11/06/2022]
Abstract
CONTEXT.— A number of fibro-osseous and osteocartilaginous lesions, especially common in the small bones of hand and feet, pose a diagnostic challenge and have historically been thought to be reactive lesions. However, modern molecular techniques when supplementing clinical, radiographic, and histologic evaluation suggest they may, in fact, be neoplasms. OBJECTIVE.— To review the clinical presentation and histopathologic, molecular, and radiologic features of selective bone lesions, focusing most specifically on subungual exostosis, florid reactive periostitis, and bizarre periosteal osteochondromatous proliferation. DATA SOURCES.— Literature review and personal experience are the source of this review. CONCLUSIONS.— Some lesions previously thought to be reactive are locally aggressive and demonstrate reproducible molecular abnormalities, and thus may be neoplasms. Although most common in the bones of the fingers and toes, these lesions also occur in long and other bones. The clinical presentations, radiologic appearances, and histopathologic features often overlap, making the diagnosis challenging, and these lesions may require molecular evaluation to maximize accurate prognostication.
Collapse
Affiliation(s)
- Raima A Memon
- From the Departments of Pathology & Genetics, University of Alabama at Birmingham
| | - Shi Wei
- From the Departments of Pathology & Genetics, University of Alabama at Birmingham
| | - Gene P Siegal
- From the Departments of Pathology & Genetics, University of Alabama at Birmingham
| |
Collapse
|
10
|
Benign bone tumours of tibial tuberosity clinically mimicking Osgood-Schlatter disease: a case series. INTERNATIONAL ORTHOPAEDICS 2019; 43:2563-2568. [DOI: 10.1007/s00264-019-04397-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Accepted: 08/14/2019] [Indexed: 12/16/2022]
|
11
|
Sakamoto A, Shiba E, Matsuda S. Florid reactive periostitis of the metacarpal bone: a case of resolution without resection. J Hand Surg Eur Vol 2018; 43:1118-1119. [PMID: 30114991 DOI: 10.1177/1753193418791659] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Akio Sakamoto
- 1 The Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Eisuke Shiba
- 2 The Department of Pathology and Oncology, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Shuichi Matsuda
- 1 The Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| |
Collapse
|