Case Of Osteoid Osteoma Research Articles

Subchondral Osteoid Osteoma of a Metatarsal Bone: An Uncommon Variant in an Unusual Location

Osteoid osteoma (OO) is a benign bone-forming lesion leading to classical symptoms in the form of pain that aggravates during the night and is relieved by the treatment with salicylates. It constitutes 10% of benign skeletal neoplasms and is seen most often in males between the age group of 7 and 25 years. We report a rare case of subchondral OO of a metatarsal bone with unusual imaging features. This case illustrates the limitations of various imaging modalities in the diagnosis of bone tumors and the need for biopsy and histopathological analysis in difficult cases.

Spinal osteoid osteoma: Surgical resection and review of literature.

Background: Osteoid osteoma (OO) is a rare benign tumor of the spine that involves the posterior elements with 75% tumors involving the neural arch. The common presenting symptoms include back pain, deformity like scoliosis, and rarely radiculopathy.Methods: From 2011 to 2017, we evaluated cases of OO managed by posterior surgical resection while also reviewing the appropriate literature.Results: We assessed five patients (three males and two females) averaging 36.60 years of age diagnosed with spinal OOs. Two involved the lumbar posterior elements, two were thoracic, and one was in the C3 lateral mass. All patients underwent histopathological confirmation of OO. They were managed by posterior surgical resection with/without stabilization. No lesions recurred over the minimum follow-up period of 24 months.Conclusion: Surgical excision is the optimal treatment modality for treating spinal OOs. The five patients in this study demonstrated good functional outcomes without recurrences. Further, the literature confirms that the optimal approach to these tumors is complete surgical excision with/without radiofrequency ablation.

Arthroscopic management of intra- and juxta-articular osteoid osteoma of the upper extremity: a systematic review of the literature.

Intra- and juxta-articular osteoid osteoma (OO) is rare and can result in irreversible joint damage. Recently, arthroscopic surgery is being used more and more to avoid complications associated with other treatment modalities. On October 13, 2019, we conducted a systematic review of the literature available in PubMed and EMBASE regarding the arthroscopic management of OO involving the joints of the upper extremity. Predetermined inclusion criteria were used to include any relevant article published on and before that date for further analysis. Treatment success rate and tumor recurrence rate were considered the primary outcomes in our analysis. Out of 113 studies, 19 met our inclusion criteria. Of the 32 reported cases in these 19 articles, ten involved the shoulder joint, 19 involved the elbow joint and three involved the wrist joint. Overall treatment success rate was 93.8%. Tumor recurrence rate was 0.0%. No postoperative complications (0.0%) were reported among cases involving the shoulder joint. Two out of 24 (8.3%) patients with elbow OO failed arthroscopic treatment due to incomplete excision, and two (4%) experienced minor complications. Among the three cases of wrist OO, two (66.7%) patients had residual postoperative pain and decreased hand grip strength. Arthroscopic management of OO of the upper extremity joints is highly successful and results in no tumor recurrence; however, there is a risk of incomplete resection in areas more difficult to access by arthroscopy.

Osteoid Osteoma of the Metacarpal – Difficulties In the Diagnosis: A Case Report

Objective − To present a rare case of osteoid osteoma of the metacarpal bone and to emphasize the importance of correlation of radiological analysis with anamnestic data and clinical findings. Case Report − We reported the case of osteoid osteoma of the metacarpal bone in a 14-year old girl. The patient, a volleyball player, presented with pain in the left hand. At first, nonsteroidal anti-inflammatory drugs relieved the pain but over the time it became more intense and was accompanied with swelling. On the basis of magnetic resonance imaging (MRI), the case was misdiagnosed as a status post-fracture of three metacarpal bones. After inappropriate treatment with physical therapy, the patient’s condition worsened, thus multiple laboratory tests and radiology imaging techniques were performed to achieve the right diagnosis. Diagnosis of osteoid osteoma was finally made by CTscan and appropriate treatment by surgical ablation was performed. Conclusion − Osteoid osteoma rarely occurs in metacarpal bones. Physicians should be aware of the atypical clinical presentation of this benign lesion in the metacarpal bones.

Osteoma osteoide raquídeo recidivante en forma de osteoblastoma agresivo

We report an uncommon case of osteoid osteoma recurring as an aggressive osteoblastoma of the spine. A 15-years-old male consulted in our department with long-term painful scoliosis. The CT-scans and MRI revealed a sclerotic bone forming tumor of 7mm diameter consistent with a osteoid osteoma. A percutaneous radiofrequency ablation was performed with complete resolution of the symptoms. After 6 months, the symptoms recurred. A new CT and a MRI showed a growth of the nidus on the right L4 lamina, with a size of 15mm. Therefore, a marginal resection by laminectomy of L4 was performed. Pathology confirmed an epithelioid osteoblastoma. A year later, subsequent imaging studies showed a new recurrence with aggressive features and invasion of the spinal canal. The patient then underwent an "in block surgery" needing concurrent stabilization of the spine. Histopathology confirmed the diagnosis of epithelioid osteblastoma.

Osteoid Osteoma About the Hip in Children and Adolescents.

The etiology of hip pain in pediatric and adolescent patients can be unclear. Osteoid osteoma (OO) about the hip in children has only been described in case reports or small studies. The present study assessed the clinical presentation and diagnostic course, imaging, and treatment approaches in a large cohort of pediatric cases of OO about the hip. Medical record and imaging results were reviewed for all cases of OO identified within or around the hip joint in patients <20 years old between January 1, 2003, and December 31, 2015, at a tertiary-care pediatric center. Demographic, clinical, and radiographic data were analyzed. Fifty children and adolescents (52% female; mean age, 12.4 years; age range, 3 to 19 years) were identified. Night pain (90%) and symptom relief with nonsteroidal anti-inflammatory drugs (NSAIDs) (88%) were common clinical findings. Sclerosis/cortical thickening was visible in 58% of radiographs, although a radiolucent nidus was visible in only 42%. Diagnostic imaging findings included perilesional edema and a radiolucent nidus on 100% of available magnetic resonance imaging (MRI) and computed tomography (CT) scans, respectively. Initial alternative diagnoses were given in 23 cases (46%), the most common of which was femoroacetabular impingement (FAI). Delay in diagnosis of >6 months occurred in 43% of patients. Three patients underwent operative procedures for other hip diagnoses, but all had persistent postoperative pain until the OO was treated. Of the 41 patients (82%) who ultimately underwent radiofrequency ablation (RFA), 38 (93%) achieved complete post-RFA symptom resolution. Initial misdiagnosis, the most common of which was FAI, and delayed correct diagnosis are common in pediatric OO about the hip. Presenting complaints were variable and nonspecific MRI findings were frequent. Night pain and relief with NSAIDs were present in the vast majority of cases. CT scans provided definitive diagnosis in all patients who received them. As increasing numbers of young, active patients are being evaluated for various causes of hip pain, such as FAI, OO should not be overlooked in the differential diagnosis. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

A misdiagnosed case of osteoid osteoma of L5

Clinically, it is difficult to differentiate osteoid osteoma, more than 50% of which occur in the fibia or tibia, from other diseases, i.e. spinal degenerative diseases, inflammatory and noninflammatory arthritis. In this case report, we presented an unusual case of lumbar osteoid osteoma in a 38-year-old male, who experienced low back pain and sciatica as initial symptoms. The patient was initially misdiagnosed as lumbar disc herniation for more than 10 years. With the usage of computed tomography (CT) and magnetic resonance imaging (MRI), the patient was finally diagnosed as osteoid osteoma in L5. To our knowledge, spinal osteoid osteoma with sciatica as initial symptoms has never been reported. Although lumbar vertebra osteoid osteoma is clinically uncommon, it should be taken into consideration especially when patients experience long duration of pain in lumbar.

Outcome of curettage of peritrochanteric benign lesions in skeletally immature patients without internal fixation

Background Peritrochanteric benign lesions are common in skeletally immature patients, which might cause limping and bone destruction up to pathological fracture. Many techniques have been described for the treatment of such lesions; curettage is one of them, which may be combined with bone graft and internal fixation. Curettage without internal fixation is the principal technique used in this study. Patients and methods This study included 20 patients, with 12 males and eight females, and their mean age was 10.6 years (range, 4–15 years). The diagnosis was 12 cases of simple bone, three cases of aneurysmal bone cyst, two cases of fibrous dysplasia, two cases of nonossifying fibroma, and one case of osteoid osteoma. Treatment included curettage, either simple or extended by high-speed burr and phenol adjuvant, and only cast as external immobilization. Patients were placed in hip spica or antirotational cast for 6–8 weeks. The visual analog scale (VAS) and Harris hip score (HHS) were used for preoperative and postoperative clinical and functional assessments. Results The mean follow-up period was 30.5 months. Clinically, 17 patients had full recovery 3–6 months postoperatively with excellent results according to HHS for hip function and VAS for pain assessment. The VAS score decreased highly significantly, which denoted pain improvement after treatment. HHS increased highly significantly, which denoted improvement of functional activity after treatment. Three patients developed complications. Conclusion Curettage without internal fixation and its replacement by external immobilization by cast is effective, less morbid, and technically simple procedure for the treatment of peritrochanteric benign lesions in skeletally immature patients. Good satisfactory results in local tumor control and excellent long-term functional and radiological results with less emotional negative effects on the patient or his family have been recorded.

Proximal Phalanx Osteoid Osteoma: A Case Report and Literature Review.

Summary: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.

A misdiagnosed case of osteoid osteoma of the talus: a case report and literature review

BackgroundOsteoid osteoma (OO) is a common benign bone tumour that is rarely found in the talus. Its nidus is difficult to detect on early imaging. The atypical symptoms of OO and the presence of concurrent trauma or sports injuries may lead to misdiagnosis and delayed treatment. We herein analyse a case of misdiagnosis of OO of the talus and discuss how to improve the early diagnosis of this rare lesion, thereby permitting rapid treatment.Case presentationA 23-year-old man with a history of left ankle sprains and chronic pain was diagnosed with another ankle sprain and managed conservatively based on normal X-ray findings. After 1 year of recurring pain, he was diagnosed with ankle traumatic arthritis and underwent arthroscopic surgery. His preoperative ankle X-ray findings were still normal, and magnetic resonance imaging at that time demonstrated bone marrow oedema of the left talus. His symptoms reappeared shortly after surgery and progressively worsened. Magnetic resonance imaging performed 3 months after surgery demonstrated widespread bone marrow oedema of the talus. The patient presented to our hospital for pain assessment and was diagnosed with OO of the talus 3 years after his symptoms began. Preoperative computed tomography (CT) demonstrated a typical nidus of OO of the talus. After a second surgery, the patient’s symptoms completely resolved, and pathologic examination confirmed that the lesion was OO. The patient recovered 3 months later and was able to walk normally.ConclusionsOO of the ankle joint exhibits a progressive course and is difficult to diagnose at an early stage. Patients with OO of the talus often have atypical imaging findings, no signs of ankle instability, and no anterior talofibular ligament tenderness. CT is valuable for diagnosing OO, although multiple CT scans may be required to detect the nidus. Proper imaging helps doctors to achieve the correct diagnosis early in the disease course, significantly shortening the treatment cycle and improving the patient’s quality of life.

A case of osteoid osteoma arising from left femoral neck treated with CT guided radio frequency ablation

A case of osteoid osteoma arising from left femoral neck treated with CT guided radio frequency ablation

A multicenter cohort study of spinal osteoid osteomas: results of surgical treatment and analysis of local recurrence

Background ContextSpinal osteoid osteomas are benign primary tumors arising predominantly from the posterior column of the spine. These “osteoblastic” lesions have traditionally been treated with intralesional excision. PurposeThe purpose of the present study was to review the treatment and local recurrence rates for symptomatic spinal osteoid osteomas. Study Design/SettingMulticenter ambispective cross-sectional observational cohort study. Patient SampleDuring the study period, a total of 84 patients (65 males, 19 females) were diagnosed with a spinal osteoid osteoma and received surgical treatment. The mean age at surgery was 21.8 ± 9.0 years (range: 6.7–52.4 years) and the mean follow-up was 2.7 years (13 days–14.5 years). Outcome MeasuresLocal recurrence, perioperative morbidity, and cross-sectional survival. MethodsUsing the AOSpine Knowledge Forum Tumor multicenter ambispective database, surgically treated osteoid osteoma cases were identified. Patient demographic, clinical and diagnostic, treatment, local recurrence, perioperative morbidity, and cross-sectional survival data were collected and retrieved. Descriptive statistics were summarized using mean/standard deviation or frequency/percentage. ResultsIn our study, most of the tumors were localized in the mobile spine (81 of 84 [96%]); all patients reported pain as a symptom. According to the postoperative assessment, 10 (12%) patients received an en bloc resection with marginal or wide margins, whereas two (2%) patients received en bloc resections with intralesional margins, 69 (82%) patients were treated by piecemeal “intralesional” resection, and three (4%) patients were not assessed. A total of six patients (7%) experienced a local recurrence, all of which occurred in patients who had received an intralesional resection. ConclusionsBenign bone-forming tumors of the spine are uncommon. Most patients in our series underwent a piecemeal resection with intralesional margins. This remains safe with a low local recurrence rate. En bloc excision may provide more chance of complete excision of the nidus but is not mandatory. The importance of complete excision of the nidus cannot be overemphasized.

EFFICACY OF BIOACTIVE GLASS AND ALLOGENIC BONE IN REPAIR OF BONE DEFECT AFTER BENIGN BONE TUMOR CURETTAGE

To compare the healing process and clinical results of bioactive glass and allogenic bone in the repair of bone defects after benign bone tumor curettage. Between November 2011 and December 2012, 20 patients with benign bone tumor received bioactive glass and allogenic bone for repair of bone defects after benign bone tumor curettage. There were 17 males and 3 females, aged 9-68 years (median, 18.5 years). The mean course of disease was 3.3 months (range, 1-9 months). Pathological examination revealed that there were 7 cases of chondroblastoma, 5 cases of bone cyst, 2 cases of non-ossifying fibroma, 2 cases of enchondroma, 1 case of vascular tumor of bone, 1 case of lipoma of bone, 1 case of osteoid osteoma, and 1 case of chondromyxoid fibroma. The lesion located at the femur in 5 cases, at the tibia in 11 cases, at the humerus in 1 case, at the calcaneus in 2 cases, and at the talus in 1 case. The bioactive glass and allogenic cancellous bone were implanted in the cavity at the same time. The Musculoskeletal Tumor Society (MSTS) function evaluation score was used for evaluation of postoperative limb function. According to the imaging and clinical benefit, the healing processes of two kinds of implants were evaluated. The healing rate and healing time were compared. The distribution of the bioactive glass was divided into two layers: the layer close to host bone and the layer close to allogenic bone. The bone ingrowth time and bone resorption time in different layers were evaluated and compared. All cases were followed up 12-42 months (mean, 34.5 months). All incisions healed by first intention. There were no complications of wound infection or deep infection, rejection, nonunion of bone, fracture at bone graft site, and collapsing of articular surface. There was no tumor recurrence during follow-up. The mean MSTS functional score was 29.5 (range, 28-30) at last follow-up. Complete healing was observed in 11 cases and healing in 9 cases. The healing rates of two kinds of implants were both 100%. The healing time of bioactive glass and allogenic bone was (4.7±1.3) months and (5.2±1.6) months, respectively, showing no significant difference (t=-1.240, P=0.244). The bone ingrowth time and the bone absorption time were (3.6±0.9) months and (3.7±1.0) months in the layer close to host bone and were (4.2±1.3) months and (4.2±1.3) months in the layer close to allogenic bone, all showing no significant difference (t=1.785, P=0.097; t=1.476, P=0.172). For the repair of bone defects after benign bone tumor curettage, bioactive glass can achieve satisfactory healing result and has good safety.

An unusual case of osteoid osteoma occurring simultaneously with an ameloblastoma: a case report

Dual pathology of head and neck lesions is well reported in patients with syndromes; however, only one previous case of an odontogenic tumour associated with a benign bone lesion can be found. Osteoid osteoma is a rare benign osteogenic tumour of unknown aetiology, commonly affecting the long bones of males, rarely occurring in the head and neck. This case report reviews an adolescent presenting with an ameloblastoma and an unsuspected additional bony lesion, subsequently diagnosed as osteoid osteoma. This report demonstrates not only unusual clinical presentation occurring within a non-syndromic patient but also highlights the importance of vigilance in clinical and radiographic examination.

Two cases of osteoid osteoma in skulls dating from the 13–14th centuries from St. Elisabeth’s Church in Wrocław, Poland

In the study two human skulls recovered from archaeological excavations at St. Elizabeth’s Church in Wrocław, dating from the 13-14th centuries were assessed. Direct measurements of each skull were recorded, and X-ray images in P-A, lateral and basal projections were taken. The skulls represented adult males. Large, bony, lobular tumours were found on the palatine bones of both skulls. X-ray examination identified these tumours as osteoid osteomas, which are benign bone tumours that may originate in the periosteum or may be located inside the bone, distorting the maxilla or mandible. However, osteoid osteoma of the palatine is very rare. This study extends our knowledge regarding the health and diseases of historical populations.

Atypical Location of Osteoid Osteoma in Patients Referred to Orthopedic Hospital in Tabriz

Background: Osteoid osteoma is a painful bone tumor that usually affects long bones. The unusual location of osteoid osteoma is rare and may be misleading and misinterpreting the diagnosis. Objective: The objective of current study was to determine and explain the unusual cases of Osteoid osteoma found in atypical location (the coccyx, iliac bone, toe, vertebral body and scapula) of patients that were referred to our institution. Patients and Methods: We examined the imaging features: Plain Film, CT Scan, MRI, Scan isotope that could alert the radiologists toward a correct diagnosis. For reviewing the literature in the field, we extracted all publications indexed as a MeSH Major Topic of “osteoma, osteoid” in MEDLINE database via PubMed search engine throughout 2006-2015. We restricted our search to case reports. Results: We determined 5 patients with atypical location of osteoid osteoma in patients referred to our hospital during years 2014-2015. The literature review of osteoid osteoma in MEDLINE showed that, there have been only 134 rare case reports about osteoid osteoma which were published and indexed in MEDLINE during the last decade (2006-2015). The rarest of rare case reports for osteoid osteoma was in Maxilla, Nasal, Ribs, and Sarcrum. Conclusion: Analysis of our study concluded that the physicians should bear in mind, the probability of osteoid osteoma, when they are considering the chronic pain in the atypical areas of patients’ body.

What makes CT guided radiofrequency ablation for osteoid osteoma superior to open surgery in terms of pain control and patient’s quality of life?

PurposeTo demonstrate our experience in percutaneous radiofrequency ablation (RFA) as a minimally invasive therapy for patients with osteoid osteoma. Patients and methodsWe will highlight cases of osteoid osteoma treated by minimally invasive therapy (RFA) and the role of image guidance in making the procedure rapid outpatient service instead of hospitalization and morbidity of open surgery. This will include 15 patients (10 males & 5-females) aged 12–35years, (mean 20), their clinical and radiological diagnosis was osteoid osteoma. All patients were treated by CT guided percutaneous RFA under spinal and epidural anesthesia. Results14 (93.3%) of the 15-patients had prompt improvement of clinical symptoms and pain relief, one patient underwent second session of re-ablation. The mean follow-up period was 12months and no patient had pain recurrence. ConclusionPercutaneous RFA is a safe and effective minimally invasive outpatient treatment for osteoid osteoma with low cost, low morbidity, better quality of life when compared with open surgery.

Radionuclide imaging in the diagnosis of osteoid osteoma.

Oseteoid osteoma is a well-known type of benign bone-forming tumor, which has previously been diagnosed using plain radiograph imaging. However, diagnosis of osteoid osteoma may be delayed due to ambiguities on plain radiograph images; despite the increasing use of magnetic resonance imaging (MRI), this type of misdiagnosis is not uncommon. The aim of the present study was to evaluate the effectiveness of radionuclide imaging scans for the diagnosis of osteoid osteoma, as this form of imaging was proposed to be a more sensitive test. The characteristics of 18 cases of osteoid osteoma were analyzed based on diagnostic imaging and the time from initial recognition of symptoms by the patient to diagnosis. Diagnostic modalities included plain radiograph, computed tomography (CT), MRI and radionuclide imaging. Among the 18 patients, 14 patients had unique positive findings in plain radiographs. The mean duration between initial cognition of symptoms to the diagnosis for these patients was 5.2 months (range, 3.8-9.3 months). A total of 4 patients exhibited no radiographic abnormalities in the initial plain radiographs and were diagnosed a mean of 18.5 months (range, 17-20 months) following the onset of symptoms. Overall, radionuclide imaging was performed on 16 patients and all of the cases demonstrated positive findings. In these cases, 28.6% of osteoid osteoma patients with clinical indications revealed no abnormal findings in plain radiographs. Therefore, in situations such as these, radionuclide imaging may be a useful indicator for diagnosis, as these results have demonstrated that it positively identified all cases of osteoid osteoma. In addition, the results of the present study indicated that if the radionuclide imaging was positive, CT scan was a more valuable diagnostic tool, whereas if the radionuclide imaging was negative, MRI should be recommended for the diagnosis of other undiscovered disease entities.

Carpal tunnel syndrome: A rare manifestation of distal radius osteoid osteoma.

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.

Osteoid Osteoma of the Trapezium in a Forty-Five-Year-Old Man

Introduction: Osteoid Osteoma (OO) is uncommon in the carpal bones and extremely rare in the trapezium. We report the third case of OO of the trapezium. Case Presentation: Patient was a 45- year -old man with chronic left wrist pain for 19 months. Pain was intense at night and responsive to nonsteroidal anti-inflammatory drugs. There was a local tenderness on the trapezium. The wrist X-ray images revealed normal findings, but bone scan, computed tomographic scan, and magnetic resonance imaging indicated OO as the possible diagnosis. The patient was treated by curettage and bone graft of the trapezium. Histopathologic examination confirmed the diagnosis of OO. Discussion: OO of the trapezium should be included in differential diagnosis list in patients with chronic wrist pain.