Abstract
Presented here is a case of a young woman, with an undiagnosed osteoid osteoma of the spine, which presented with painful scoliosis in adolescence and was treated by bracing until her accession to adulthood. A more thorough investigation, years after the initial one, revealed the tumor. Surgical excision and stabilization offered the long-awaited cure. Misdiagnosis resulted in intractable pain for years, deformity, the discomfort of brace therapy, and the frustration of a prolonged yet ineffective treatment.
Highlights
The most common cause of painful scoliosis in adolescents is osteoid osteoma of the spine [1]
The peak incidence of osteoid osteomas occurs in adolescence [2]
Back ache is an uncommon complaint in adolescents and young adults, and when it occurs in association with paravertebral muscle spasm and scoliosis, osteoid osteoma of the spine must be suspected [3]
Summary
The most common cause of painful scoliosis in adolescents is osteoid osteoma of the spine [1]. Presented here is a case of a young woman, who presented with painful scoliosis in adolescence and was treated by bracing until her accession to adulthood, without the osteoid osteoma she suffered from being diagnosed. The patient presented initially at the age of 15 years Her main symptom was diffuse pain on the thoraco-lumbar spine. CT scanning of the spine revealed a tumor on the left posterior arch of T12, which affected the lamina, pars interarticularis and inferior facet process (figure 2). She was promptly subjected to a full radiologic examination, where no other lesions were found. On the latest follow up the patient remains asymptomatic, and lives an active, unconstrained life (figure 4)
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