Das Osteoidosteom im Bereich der Hand und des Handgelenks

[Three-year-old child with osteoid osteoma of the thumb: Diagnostic and therapeutic challenge]

A three-year-old girl experienced a fifteen-month odyssey before the surgical removal of an osteoid-osteoma at the distal phalanx of the thumb to relieve her pain. Osteoid-osteoma is a benign bone tumor rarely found in the hand and not yet described as occurring in a small child in extant literature. In one of the first x-ray examinations, a small foreign body was found in the soft tissues of the right thumb. This finding subsequently led to the assumption that trauma was the cause for the pain.We critically discuss the numerous examinations and therapies that the child underwent as well as the lack of interdisciplinary cooperation among specialists for more than a year. The thumb was immobilized for months because of pain and is slowly being reintegrated into the child's body scheme following the last successful intervention.This publication highlights this tumor's rare occurrence in a small child and the importance of interdisciplinary cooperation facilitated today by digital media. This, along with early diagnosis, could save unnecessary suffering and financial resources.

Femur shaft fracture following osteoid osteoma radiofrequency ablation

Introduction

Radiofrequency ablation is an effective modality in treating osteoid osteoma while avoiding the complications of an open procedure. Its complications are usually self-limited consisting mostly of local skin burns. This report presents a major complication, a femur shaft fracture following an osteoid osteoma radiofrequency ablation. The fracture occurred approximately one year after the ablation at the site of the osteoid osteoma.

Discussion

Few case reports have been published regarding subtrochanteric femur fracture after ablation of an osteoid osteoma. To our knowledge this is the first report of a femoral shaft fracture following an ablation. Another unique characteristic of the presented case is the late presentation, approximately one year following ablation. Factors which may have contributed to the fracture include lateral entry point of the drill which may have weakened the femur when taking its biological and mechanical properties into account, and the fact that the patient was a soldier who was allowed to continue his military training only six weeks after the ablation.

Conclusion

Radiofrequency ablation is an effective and relatively safe technique in treating osteoid osteomas, however the physician should be aware of the fracture risk involved, consider mechanical and biologic factors of the bone prior to drilling, and be very conservative when recommending return to high level activity. In addition, a close follow-up should be carried on after the procedure in order to supervise bone remodeling.

Osteoid osteoma of the hand and foot in children successfully treated with radiofrequency neurotomy probes

Osteoid osteoma is a common benign tumor that is typically found in young adults and children, usually in the long bones of the lower extremity. Radiofrequency ablation (RFA) under computed tomography guidance is the standard of care for symptomatic osteoid osteomas. However, patients with osteoid osteoma of the hand or foot are often treated with open surgery because of the risk of injury to vascular and neural structures from RFA. This risk is more pronounced in pediatric patients because of the small lesion size and proximity of lesions to important neurovascular structures. Here, we present 2 pediatric patients, one with an osteoid osteoma in the hand and the other with an osteoid osteoma in the foot. In both patients, a 22-gauge, 2.5-mm active tip ablation probe was used. The smaller ablation volume achieved with this probe protected neighboring neurovascular structures while effectively ablating the osteoid osteoma nidus. Based on our success in these cases, we recommend the application of this method for cases in which neurovascular proximity to the osteoid osteoma lesion makes ablation challenging.

Osteoid osteoma of the pisiform: A case report

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.

Osteoid Osteoma of the Ulnar Head-An Uncommon Cause of Ulnar Wrist Pain

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.

Osteoid osteoma of mandible

Osteomas are benign, slow-growing osteogenic tumours rarely occurring in the craniofacial bones. Osteomas are characterised by the proliferation of compact and/or cancellous bone. It can be of a central, peripheral, or extra skeletal type. The peripheral type arises from the periosteum and is rarely seen in the mandible. The lingual surface and lower border of the body are the most common locations of these lesions. They are usually asymptomatic and can be discovered in routine clinical and radiographic examination. In this paper, the authors present a large solitary peripheral osteoma located in the inferior surface of the left angle of mandible and causing facial deformity in a 14-year-old boy. Radiographic examination by diagnostic radiographs revealed mixed appearance (radiopaque- radiolucent), well-circumscribed, pedunculated mass approximately 3.5 cm in size. The osteoma was removed surgically, and no recurrence has been observed.

[Intra-articular osteoid osteoma of the hip: two cases and review of the literature]

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.

Ostéome ostéoïde du lunatum: à propos d'un cas

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.

Pathologic Conditions of the Hypothenar Eminence: Evaluation with Multidetector CT and MR Imaging

Pain, weakness, and sensory loss occur frequently in the hypothenar eminence. However, clinical examination is difficult and nonspecific, and the prescribed imaging technique may be inadequate, or images may be misinterpreted. Different imaging modalities have various degrees of usefulness for the diagnosis of painful pathologic conditions of the hypothenar eminence. Radiography, multidetector computed tomography (CT), multidetector CT arthrography, and magnetic resonance (MR) imaging of the wrist are useful for surveying the anatomy of the hypothenar eminence, the Guyon canal, and the ulnar nerve and artery and for determining the cause of pain or other symptoms. A fracture of the pisiform bone or the hook of the hamate bone, osteoarthritis or osteochondromatosis of the pisotriquetral joint, Guyon canal syndrome, hypothenar hammer syndrome, tendinopathy of the flexor carpi ulnaris, an anomalous muscle, a ganglion cyst, or a tumor may be responsible for ulnar neuropathy. Specific radiographic views, such as the semisupinated oblique view and the lateral view with the hand radially deviated and the thumb abducted, often provide a sufficient basis for the diagnosis of acute fracture of the hook of the hamate or the pisiform bone. Multidetector CT angiography is an efficient method for diagnosing hypothenar hammer syndrome, and multidetector CT arthrography is well suited for evaluation of the pisotriquetral joint. MR imaging is the modality of choice for depiction of the ulnar nerve.