1/11. Osteoid osteoma of the elbow: a diagnostic challenge.BACKGROUND: Osteoid osteoma is a painful benign neoplasm that is rarely found in the elbow region. methods: The study included fourteen patients, and we believe that this is the largest reported series of patients with osteoid osteoma of the elbow evaluated at one institution. Most of the patients had had symptoms for a prolonged period and had had multiple invasive procedures before an accurate diagnosis was made. Although findings on physical examination generally are nonspecific and are not always accurate in localizing the lesion, plain tomograms and computed tomography scans were most helpful in identifying the nidus in the present study. Thirteen of the patients had limited motion of the elbow before the definitive diagnosis was made, and ten of these thirteen had a mean flexion contracture of 38 degrees. RESULTS: Removal of the nidus resulted in relief of pain and improvement in the range of motion of the elbow in all fourteen patients. A persistent postoperative flexion contracture was more common in the patients who had had a previous arthrotomy of the elbow than in those who had not had that procedure. CONCLUSIONS: It is important to recognize this uncommon entity to avoid the morbidity associated with a prolonged delay in diagnosis. Because the symptoms resolve after excision of the lesion, the surgeon can avoid unnecessary soft-tissue dissection and release of the contracture.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
2/11. Osteoid osteoma of the elbow in children: a report of three cases and a review of the literature.Although osteoid osteoma is a relatively common lesion, it is rarely found at the elbow. We report three cases of osteoid osteoma of the olecranon fossa in patients under the age of 15 years. diagnosis was delayed because of nonspecific clinical and radiological features. The three patients suffered from synovitis due to flexion contracture while at the same time prosupination remained normal. Only one patient complained of specific nocturnal pain. All cases had a latency between the onset of symptoms and the appearance of radiological signs. Open surgical excision of the nidus resulted in relief of pain in all cases and motion recovery in two cases. Diagnostic difficulties and treatment options are discussed.- - - - - - - - - - ranking = 0.5keywords = motion (Clic here for more details about this article) |
3/11. Excision of an osteoid osteoma from the body of the axis through an anterior approach.Osteoid osteoma is seen less commonly in the vertebral body than in the posterior elements of the spine. To the authors' knowledge, this is only the second reported case of an osteoid osteoma affecting the body of the axis. The patient described in this report presented with the classic symptomatology of pain and torticollis. Radiological imaging confirmed the diagnosis. A superior extension of the anterior Smith-Robinson approach, through the "window of access" described by Fasel, was used to excise this lesion. Following surgical excision, there was complete resolution of the presenting symptomatology and functionally the range of motion of the cervical spine returned to normal. We avoided instrumentation and C1-C2 fusion so that rotation of the cervical spine could be maintained. There were no signs of recurrence of the tumour within the 4-year follow-up period. It presented in a classic way but, despite this, it took 2 years from the onset of these symptoms to reach a definitive diagnosis. This osteoid osteoma was successfully excised through a superior extension of the anterior Smith-Robinson approach.- - - - - - - - - - ranking = 0.5keywords = motion (Clic here for more details about this article) |
4/11. The diagnostic and therapeutic challenge of femoral head osteoid osteoma presenting as thigh pain: a case report.Osteoid osteoma, an infrequent but important cause of musculoskeletal pain, is often difficult to diagnose. We present a case of a 31-year-old man who, for 2 years, had left groin pain radiating to the thigh. Symptoms began 1 month after a motorcycle crash in which he sustained only shin abrasions. Initial spine and hip radiographs were negative. Treatment with naproxen provided significant relief, but the symptoms gradually worsened over 6 months. An electromyogram and lumbar magnetic resonance imaging (MRI) of the left lower leg were unremarkable. hip MRI revealed edema without fracture. Prophylactic femoral pinning for impending stress fracture provided no relief. Rheumatologic evaluation revealed normal serologies and synovial fluid. Cyclobenzaprine and sulfasalazine were started and provided mild relief. At presentation to our institution, he was in significant discomfort, but could ride a bicycle for exercise and was completing a home exercise program. He had antalgic gait and globally restricted hip motion with end-range pain. A neurologic examination showed no abnormalities. hip and pelvis computed tomography scan revealed increased sclerosis of the femoral head, with a central lucency suggestive of osteoid osteoma. This was confirmed by biopsy. Radiofrequency ablation provided significant symptom relief.- - - - - - - - - - ranking = 0.5keywords = motion (Clic here for more details about this article) |
5/11. Tibialis spastic varus foot caused by osteoid osteoma of the calcaneus.Tibialis spastic varus foot is an extremely rare condition. A 30-year-old man had tibialis spastic varus foot caused by juxtaarticular osteoid osteoma of the calcaneus. The correct diagnosis was delayed because the symptoms were similar to arthritis and the nidus was difficult to detect on plain radiographs. curettage of the tumor was done, and the osseous defect was filled with interporous hydroxyapatite. The pain was relieved immediately after surgery. The varus deformity of the foot and spasm of the tibialis anterior muscle gradually improved. Three years 10 months after surgery, the patient was pain-free and the spasm of the tibialis anterior muscle had disappeared. The varus deformity and motion of the foot improved, but a restricted range of motion remained. To the authors' knowledge, there have been no published descriptions of tibialis spastic varus foot caused by juxtaarticular osteoid osteoma of the calcaneus.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
6/11. Intraarticular osteoid osteoma: clinical features, imaging results, and comparison with extraarticular localization.OBJECTIVE: Intraarticular osteoid osteoma is uncommon and presents diagnostic difficulties, which are important for both rheumatologists and orthopedic surgeons. Clinical symptoms, imaging procedures, differential diagnostic problems, and treatment results of intraarticular as compared with extraarticular osteoma are analyzed in this retrospective study. methods: Nineteen patients with intraarticular osteoid osteomas (Group A), with a mean followup period of 34 months, are compared with 15 others with extraarticular lesions (Group B). RESULTS: Nine intraarticular tumors were located in the hip, 3 in the elbow, 6 in the ankle, and one in the first metatarsal head. The nonspecific symptoms in Group A, such as chronic synovitis, decreased range of motion, joint effusion, contractures, and lack of the intense perifocal sclerotic margin on radiographs, led to significant delay in diagnosis (on average 26.6 mo in Group A, 8.5 mo in Group B). The extreme variety of previous diagnoses at referral reflect the problems of differential diagnosis. A detectable nidus is often absent on conventional radiograph. Bone scintigraphy is unspecific and often fails to visualize the nidus. Computed tomography scans were accurate in two-thirds of the intraarticular and in 90% of extraarticular cases. Magnetic resonance image findings, although sometimes controversial, provided essential additional information for the correct diagnosis and therapy. CONCLUSION: Clinical symptoms and imaging signs of intraarticular osteoid osteomas were significantly different from the classical hallmarks of extraarticular lesions. The 10% intraarticular occurrence of osteoid osteomas in this series is not as rare as some investigators suggest. The radiological and clinical findings are uncharacteristic and misleading, and the lesions are difficult to identify. Careful search for history data, such as nocturnal pain and positive salicylate test, in addition to extensive imaging procedures, led to the correct diagnosis prior to surgery in two-thirds of our patients with intraarticular osteoid osteomas.- - - - - - - - - - ranking = 0.5keywords = motion (Clic here for more details about this article) |
7/11. CT scan helps delineate cervical osteoid osteoma and atypical nidus.Computerized tomography proves to be particularly helpful in anatomically delineating an osteoid osteoma of the spine in an inaccessible area and in also identifying an atypical nidus. A case is presented of an 8-year-old boy with a one-year history of pain in the right shoulder and neck. Computerized tomography accurately delineated in anatomic detail the lesion along with an atypical nidus adjacent to the spinal canal, thus assuring total excision of both lesions. The patient regained normal neck and shoulder motion with no recurrence of pain.- - - - - - - - - - ranking = 0.5keywords = motion (Clic here for more details about this article) |
8/11. Intraarticular epiphyseal osteoid osteoma of the distal femur.A 9-year-old boy had pain in the medial side of the right knee with limited range of motion and limping. Roentgenography showed a small sclerotic shadow (8 X 8 mm2) in the medial femoral condyle, where bone scintigraphy revealed a high uptake area and angiography showed a nidus. Five months after initial presentation, en bloc excision was done through the posteromedial approach. Histological examination showed a network of osteoid trabeculae, differentiated osteoblasts, and multinucleated giant cells in this nidus, which were compatible with those of osteoid osteoma. Complete relief of pain was obtained at follow-up 1 year after the operation.- - - - - - - - - - ranking = 0.5keywords = motion (Clic here for more details about this article) |
9/11. Osteoid osteoma of the femoral neck stimulating an inflammatory synovitis.The case report presents a nine-year-old child with an osteoid osteoma of the femoral neck, simulating an inflammatory synovitis. Osteoid osteoma is a common benign bone tumor. However, when intracapsular lesions occur they may pose a diagnostic challenge. Nonspecific clinical signs and symptoms, such as inflammatory synovitis, joint effusion, and soft tissue swelling, may pose a problem in diagnosis and treatment. The delay in diagnosis can range from six months to two years. When the hip is involved, the patient may have nonspecific pain, limp, restricted motion, and thigh atrophy. An accurate diagnosis may be difficult to elicit, requiring detailed history and physical examination and culminating in the use of computed tomography.- - - - - - - - - - ranking = 0.5keywords = motion (Clic here for more details about this article) |
10/11. Phalangeal osteochondroma: an unusual cause of swan-neck deformity.A 4-year-old child with a proximal phalangeal osteochondroma of the index finger presented with a rigid swan-neck deformity. The dorsal apparatus overlying the tumor was stretched, causing increased tension on the central slip and thus hypertension of the proximal interphalangeal joint. Excision of the tumor resulted in complete restoration of digital motion.- - - - - - - - - - ranking = 0.5keywords = motion (Clic here for more details about this article) |
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