[Painful enlargement of the 2nd toe due to an osteoid osteoma in the distal phalanx]

[Difficulties in diagnosing an osteoid osteoma of the big toe : A case report with review of the literature]

BACKGROUND

Osteoid osteomas belong to the benign osseous neoplasia and can occur on the entire skeleton. The prolonged diagnosis of an osteoid osteoma of the great toe prompted us to prepare a case report with a literature review to identify possible sources of error and to contribute to a more expeditious diagnosis and therapy.

LITERATURE

Currently, only two case reports on osteoid osteomas of the toes are known in the German literature. Internationally, however, a large number of cases have been described, which, when viewed as a whole, present a homogeneous picture. A very clear accumulation of osteoid osteomas at the distal phalanx of the great toe suggests a possible post-traumatic aetiology. The typical NSAID-sensitive night pain is clinically unambiguous and should make one think of an osteoid osteoma at any site on the body. The symptom of macrodactyly, which is unique to the toes, is striking and may provide a helpful clue to establishing the diagnosis. The median time from symptom onset to correct diagnosis was 12 months. One possible reason for this prolonged diagnosis is the often atypical and ambiguous imaging. Surgical therapy is the method of choice for osteoid osteomas of the toes and should always be supplemented by histopathologic examination.

Osteoid osteoma of the great toe mimicking osteomyelitis: a case report and review of the literature

Osteoid osteomas are well-known benign tumors, seen generally in long bones. When seen in phalanxes or toes, they can cause a diagnostic dilemma. A young male presented to us with complaints of enlargement of the great toe and severe pain. He had had an ingrown toe-nail operation before, and this situation caused a diagnostic dilemma. In this case report, we emphasize that osteoid osteomas can cause diagnostic dilemmas and it should be kept in mind as a differential diagnosis.