Osteoid osteoma of the fibula in a female rugby player

Mwj Meirhaeghe,Jh Kirby,Pl Viviers,Jt Viljoen

doi:10.7196/sajsm.499

Mwj Meirhaeghe, Jh Kirby + Show 2 more

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Osteoid osteomas are benign osteoblastic tumours encountered relatively commonly among skeletal lesions. Despite distinct clinical findings, atypical presentations make for a challenging or delayed diagnosis which may negatively affect a patient’s quality of life in the interim. We present the case of a young female rugby player with a subperiosteal osteoid osteoma of the distal fibula – a rare location for this type of tumour.

Highlights

Patients invariably complain of pain that is most severe at night and which is usually relieved with salicylates or non-steroidal anti-in ammatory drugs (NSAIDs).[3]
We encountered a similar problem, considering that the bula is a rare localisation for an OO and that our patient displayed an atypical presentation at rst
Plain radiography is usually the most cost-e ective examination and is o en all that is required to ensure the accurate diagnosis of OO

Summary

Introduction

Ese skeletal neoplasms are most common among young patients (aged 10 - 30 years) and there is a strong male preponderance, with a 3:1 male to female ratio.[2,3] Classically, OO presents as an intracortical lesion of the sha occurring in the long bones; its location has proven to be subperiosteal, endosteal and even medullary, albeit less common.[2,4] e most frequently a ected sites include the femur and tibia (roughly 50% of all cases), while less regular manifestations include the humerus, spinal column and phalanges of the hands and feet.[2,3,4] Morphologically, tumours are characterised by an osteoid-rich central nidus embedded in a brous stroma of vascular connective tissue;[2,5] this rarely exceeds 2 cm in diameter and is surrounded by a zone of sclerotic bone tissue due to reactive bone formation.[3,6,7] Patients invariably complain of pain that is most severe at night and which is usually relieved with salicylates or non-steroidal anti-in ammatory drugs (NSAIDs).[3]. Ese skeletal neoplasms are most common among young patients (aged 10 - 30 years) and there is a strong male preponderance, with a 3:1 male to female ratio.[2,3] Classically, OO presents as an intracortical lesion of the sha occurring in the long bones; its location has proven to be subperiosteal, endosteal and even medullary, albeit less common.[2,4] e most frequently a ected sites include the femur and tibia (roughly 50% of all cases), while less regular manifestations include the humerus, spinal column and phalanges of the hands and feet.[2,3,4] Morphologically, tumours are characterised by an osteoid-rich central nidus embedded in a brous stroma of vascular connective tissue;[2,5] this rarely exceeds 2 cm in diameter and is surrounded by a zone of sclerotic bone tissue due to reactive bone formation.[3,6,7] Patients invariably complain of pain that is most severe at night and which is usually relieved with salicylates or non-steroidal anti-in ammatory drugs (NSAIDs).[3] Local tenderness is typically the only nding during physical examination, warmth, swelling and erythema are possible, albeit less common.[2] On the whole, from a prognostic standpoint, some OO cases have been known to regress spontaneously;[2,8] the majority require surgical intervention. We report the case of a young female rugby player with a subperiosteal OO located within the distal fibula.

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