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Dolan JD, Shiver L, Wallace D, Whitehead J, Wood M, Fulcher SM. Isolated Osseous Excision in the Adult Carpus: A Narrative Review. J Hand Microsurg 2024; 16:100041. [PMID: 38855507 PMCID: PMC11144647 DOI: 10.1055/s-0043-1769748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2024] Open
Abstract
Various pathologies of the adult carpus result in clinical scenarios where excision can be considered and even recommended. In the appropriate patient population, isolated carpal excision can alleviate pain and improve mobility. Excisions of the pisiform, trapezium, and trapezoid have abundant literature evidence to support positive long-term functional outcomes. In contrast, isolated excision of the capitate, hamate, and triquetrum has limited support in the literature secondary to compromise of carpal mechanics and lead to recurrent pain. Additionally, isolated scaphoid and lunate excision are best avoided secondary to carpal collapse and should be paired with concomitant stabilizing procedures in the carpus. This article provides a comprehensive literature review of isolated excision of each osseous carpal bone, their indications, and previously assessed outcomes.
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Affiliation(s)
- Joshua D. Dolan
- Department of Orthopaedic Surgery, Medical College of Georgia, Augusta, Georgia, United States
| | - Luke Shiver
- Department of Orthopaedic Surgery, Medical College of Georgia, Augusta, Georgia, United States
| | - Doyle Wallace
- Department of Orthopaedic Surgery, Medical College of Georgia, Augusta, Georgia, United States
| | - Jonathon Whitehead
- Department of Orthopaedic Surgery, Medical College of Georgia, Augusta, Georgia, United States
| | - Matthew Wood
- Department of Orthopaedic Surgery, Medical College of Georgia, Augusta, Georgia, United States
| | - S. Mark Fulcher
- Department of Orthopaedic Surgery, Medical College of Georgia, Augusta, Georgia, United States
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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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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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Hassini L, Khalifa MA, Othman Y, Grissa Y. Osteoid osteoma of the sesamoid bone: An unusual localization. J Clin Orthop Trauma 2019; 10:1065-1067. [PMID: 31708629 PMCID: PMC6834943 DOI: 10.1016/j.jcot.2018.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Revised: 10/19/2018] [Accepted: 10/27/2018] [Indexed: 11/25/2022] Open
Abstract
Osteoid osteoma is the most common benign bone tumor because it accounts for 10-12% of all these tumors. Localized most often with long bones (75% of cases), especially in the tibia and femur, osteoid osteoma can evoke other etiologies, especially when it is juxta-articular. We report the case of an osteoid osteoma of the sesamoid in a 23-year-old patient with no particular history who presented pain at the root of his hallux evolving for 6 months. The clinical examination was without abnormalities. Standard X-rays found no lesions. The tomodensitometry of the foot showed an image "cockade" with a peripheral sclera ring. The patient underwent surgical excision with simple operative follow-up and disappearance of pain at one year of follow-up. The histopathological study confirmed the diagnosis. The osteoid osteoma of the sesamoid bone is exceptional. The diagnosis may be delayed due to misleading "articular" symptomatology.
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Affiliation(s)
- Lassaad Hassini
- Corresponding author. Department of Orthopaedic Surgery, University Hospital, Sahloul, 4000, Sousse, Tunisia.
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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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Osteoid osteoma of the pisiform: A case report. ACTA ORTHOPAEDICA ET TRAUMATOLOGICA TURCICA 2016; 50:477-9. [PMID: 27555463 PMCID: PMC6197409 DOI: 10.1016/j.aott.2016.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Revised: 09/01/2014] [Accepted: 12/24/2014] [Indexed: 12/12/2022]
Abstract
BACKGROUND Osteoid osteoma is an uncommon benign bone-forming tumor of the musculoskeletal system but it is the most common primary bone tumor of the carpal region. However, only seven cases of its pisiform involvement have been described. CASE We present a 19 year-old male patient with osteoid osteoma of the pisiform which initially could not be detected in any diagnostic study for long standing wrist pain. The patient was treated with excision and curettage. In 1 year of follow-up, the patient was asymptomatic without recurrence. CONCLUSION In cases with long standing ulnar wrist pain, one should consider osteoid osteoma of the pisiform in differential diagnosis. If an OO is suspected, thin slice CT scan in initial evaluation would be valuable in preventing the patient from misdiagnosis or delay in diagnosis.
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Abstract
Background Osteoid osteoma of the wrist is rare and treatment is still in debate. Case Description We report on a patient with osteoid osteoma of the head of the ulna, as an unusual cause of pain on the ulnar side of the wrist. The diagnostic delay was 4 years. A previous ulna shortening surgery was performed because of misdiagnosis. The diagnosis was made with bone scan and computed tomography (CT). A surgical resection was performed. The symptoms disappeared, and full range of motion was recovered. Literature Review Osteoid osteoma on the head of the ulna had never been described before. Clinical Relevance This case demonstrates that osteoid osteoma can mimic ulnocarpal impingement syndrome.
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Affiliation(s)
- Pablo Valle
- Hand and Upper Extremity Surgery Unit, Lapeyronie University Hospital, Montpellier, France
| | - Raphael Rolland
- Hand and Upper Extremity Surgery Unit, Lapeyronie University Hospital, Montpellier, France
| | - Michel Chammas
- Hand and Upper Extremity Surgery Unit, Lapeyronie University Hospital, Montpellier, France
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Basran SS, Kumar S, Jameel J, Sajid I. Carpal tunnel syndrome: A rare manifestation of distal radius osteoid osteoma. J Clin Orthop Trauma 2015; 6:190-4. [PMID: 26155056 PMCID: PMC4488031 DOI: 10.1016/j.jcot.2015.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 03/05/2015] [Indexed: 10/23/2022] Open
Abstract
Osteoid Osteoma is a benign bone tumor that normally affects long bones and rarely affects distal radius. Because of its nonspecific presentation in the wrist, it remains a diagnostic challenge. We report an unusual case of Osteoid Osteoma at distal radius having symptoms resembling that of carpal tunnel syndrome. The diagnosis was confirmed preoperatively with X-rays; bone scintigraphy, CT, and MRI, later histological examination confirmed the diagnoses. Surgical excision lead to a dramatic improvement in the condition of the patient.
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Affiliation(s)
- Sukhvinder Singh Basran
- Assistant Professor, Department of Orthopaedics, Hamdard Institute of Medical Science and Research (HIMSR), New Delhi 1100162, India,Corresponding author. Tel.: +91 8745066650 (mobile).
| | - Sandeep Kumar
- Associate Professor, Department of Orthopaedics, Hamdard Institute of Medical Science and Research (HIMSR), New Delhi 1100162, India
| | - Javed Jameel
- Assistant Professor, Department of Orthopaedics, Hamdard Institute of Medical Science and Research (HIMSR), New Delhi 1100162, India
| | - Imran Sajid
- Senior Resident, Department of Orthopaedics, Hamdard Institute of Medical Science and Research (HIMSR), New Delhi 1100162, India
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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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Aghoutane EM, El Fezzazi R. [Osteoid osteoma of the phalanx in children and diagnostic problems: report of one case]. ACTA ACUST UNITED AC 2012; 31:199-201. [PMID: 22980990 DOI: 10.1016/j.main.2012.07.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2011] [Revised: 05/08/2012] [Accepted: 07/01/2012] [Indexed: 11/26/2022]
Abstract
Osteoid osteoma is a benign osseous tumor of unknown origin, which affects preferentially the long bones. The localization in the phalanx is unusual and difficult to diagnose. We present a case of a 13-year-old girl, presenting with a painful swelling of the first phalanx of the right middle finger of 5 months duration, not responding to anti-inflammatory drugs. The diagnosis of tuberculosis of the bones was suggested at first (tuberculosis is endemic in our country), but the biology and the bone biopsy did not confirm the diagnosis. The lesion was excised, and the histology confirmed the diagnosis of osteoid osteoma. Through our observation and after a review of the literature, we analyze the clinical and paraclinical appearance of this uncommon localization, the differential diagnosis, and finally the therapeutic possibilities.
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Affiliation(s)
- E M Aghoutane
- Service de chirurgie pédiatrique A, université Cadi Ayyad, CHU Mohammed VI, Amerchich, Marrakech, Maroc.
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Tonogai I, Hamada Y, Yasui N. A CASE OF OSTEOID OSTEOMA OF THE TRAPEZOID BONE: THE EFFICIENCY OF DYNAMIC MAGNETIC RESONANCE IMAGING FOR THE DETECTION OF OSTEOID OSTEOMA LOCALIZED AT THE ATYPICAL SITE. ACTA ACUST UNITED AC 2012; 17:99-103. [DOI: 10.1142/s0218810412720057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2011] [Revised: 06/11/2011] [Accepted: 06/14/2011] [Indexed: 11/18/2022]
Abstract
The occurrence of osteoid osteoma of the carpus is rare, particularly of the trapezoid. We present a case of a ten-year-old girl with osteoid osteoma of the trapezoid in whom surgical excision of the lesion was successful. Useful information for the diagnosis of the lesion was mainly provided by dynamic magnetic resonance imaging.
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Affiliation(s)
- Ichiro Tonogai
- Department of Orthopedics, Health Insurance Naruto Hospital, Tokushima, Japan
- Department of Orthopedics, Tokushima University Hospital, Tokushima, Japan
| | - Yoshitaka Hamada
- Department of Orthopedics, Health Insurance Naruto Hospital, Tokushima, Japan
- Department of Orthopedics, Tokushima University Hospital, Tokushima, Japan
| | - Natsuo Yasui
- Department of Orthopedics, Health Insurance Naruto Hospital, Tokushima, Japan
- Department of Orthopedics, Tokushima University Hospital, Tokushima, Japan
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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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Saidi H, El Bouanani A, Ayach A, Fikry T. Ostéome ostéoïde du lunatum: à propos d'un cas. ACTA ACUST UNITED AC 2007; 26:173-5. [PMID: 17531518 DOI: 10.1016/j.main.2007.03.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2006] [Revised: 02/21/2007] [Accepted: 03/19/2007] [Indexed: 11/29/2022]
Abstract
The Osteoid Ostéome is a benign tumour which affects the young subjects and is electively located on the level of the long bones. We report a hyperalgic form of the lunatum in a young student with which surgical excision with bone-graft allowed the cure.
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Affiliation(s)
- H Saidi
- Service de traumatologie-orthopédie, CHU Mohammed VI, Marrakech, Maroc.
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Messoudi A, Fnini S, Labsaili N, Ghrib S, Rifki A, Largab A. Une double localisation d'un ostéome ostéoïde du semi-lunaire. ACTA ACUST UNITED AC 2007; 26:146-9. [PMID: 17590373 DOI: 10.1016/j.main.2007.05.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2006] [Revised: 05/11/2007] [Accepted: 05/22/2007] [Indexed: 11/23/2022]
Abstract
Osteoid osteoma is a small tumour, always benign, consisting of a small focus of osteoblastic hyperactivity surrounded by a zone of sclerosis. Located preferentially on the long bones, femur and tibia, carpal localisation is rare but if present it usually affects the scaphoid. We present a case of double localization of an osteoid osteoma in the lunate bone, presenting as gradually increasing pain in the wrist over the course of 18 months. Standard radiology and tomodensitometry of the wrist showed two central lucencies of the lunate without rupture of the cortex. Curettage of the lesion and packing of the resultant defect with cancellous bone resulted in disappearance of the lesions with good functional recovery. The clinical, radiological and therapeutic aspects will be discussed by the authors.
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Affiliation(s)
- A Messoudi
- Service de chirurgie orthopédique et traumatologique (Pavillon 32), centre hospitalier universitaire Ibn-Rochd, 45, quartier des Hôpitaux, Casablanca, Maroc.
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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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