Cases reported "Osteoma, Osteoid"

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1/10. Osteoid osteoma of the lateral talar process presenting as a chronic sprained ankle.

    Pathologic conditions of the lateral talar process may be difficult to diagnose using physical examination and roentgenographs. A computed tomography scan of the hindfoot is often useful to define lesions of the lateral process. We report a case of osteoid osteoma of the lateral talar process that defied diagnosis for 4 years. The patient had an antecedent history of an inversion injury, which had been treated as a chronically painful sprained ankle without resolution of symptoms. The tumor was ultimately identified on a computed tomography scan, best seen on a coronal section through the talus. The patient had complete relief of pain after excisional biopsy of the tumor.
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2/10. 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.
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3/10. Chronic persistent knee pain after repeated diagnostic arthroscopy: osteoid osteoma, a primarily overlooked diagnosis in a young woman.

    We report a case of osteoid osteoma of the distal femur in an adolescent female patient that was primarily overlooked and led to repeated diagnostic arthroscopy of the knee. A thorough history and physical examination of the joint as well as adequate roentgenographic studies could have spared this patient two unnecessary arthroscopies and indicated the correct therapy.
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4/10. Benign osteoblastoma of vertebral column and skull. Report of two cases.

    osteoblastoma of the spine is a rare but important cause of back pain and the sciatica syndrome in young adults. osteoblastoma of the skull is rare and the involvement of the orbital roof is very unusual. Clinical complaints and physical examination are not specific enough to provide a lead to the diagnosis. Bone scans and computerized tomography scans should be performed in all cases, to show the extent of vertebrae or calvarium infiltration by the tumor. To prevent recurrence and malignant transformation, the tumor should be completely removed whenever possible. If tumor excision is incomplete, a continuous follow-up is necessary to detect any recurrence or malignant transformation, which normally appears 5-10 years after the first operation (in one of our cases 7 years later).
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5/10. One-stage decompression and stabilization in the treatment of spinal tumors.

    Nowadays, extradural vertebral neoplasms which compress the spinal cord are being diagnosed earlier and therefore laminectomy for decompression relieves many patients of their neurological deficits before permanent cord damage has set in. In addition, radiotherapy and oncological treatment have prolonged life expectancy as well as the quality of life in these patients. As the indications for surgery have grown, the problem of spinal instability resulting from direct involvement of the supporting structures of the spine or due to the surgical procedure per se, must be considered. Many of these patients would rapidly return to leading their normal activities if not confined to bed rest or uncomfortable orthopedic devices. The Authors present 9 patients with extradural vertebral lesions: 4 plasmacytomas, 3 metastatic carcinomas, 1 malignant lymphoma and 1 aggressive osteoblastoma treated by simultaneous decompression and stabilization of the spine. All patients showed remarkable improvement of neurological symptoms except in one case where massive pulmonary embolism caused death a few hours after surgery. This surgical treatment offers the advantages of performing wider and better decompressive maneuvers and, at the same time, assuring fast mobilization of the patient after surgery who is often in poor general conditions, thus reducing post-operative complications due to delayed physical therapy and bed confinement.
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6/10. Atlanto-axial rotational limitation secondary to osteoid osteoma of the axis. Case report.

    An unusual case of atlanto-axial rotational limitation secondary to an osteoid osteoma of the axis is presented. Transoral microsurgical resection followed by physical therapy improved the clinical symptoms. This case illustrates several unique problems within the cervical spine as well as the efficacy of the transoral approach to the axis.
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7/10. Eighteen-year anamnesis of osteoid osteoma--a diagnostic problem?

    The 18-year history of osteoid osteoma in a woman aged 43 is presented. The typical physical and radiographic findings are described. Total removal of the tumor resulted in prompt and permanent relief of symptoms. diagnosis, histopathology, differential diagnosis, treatment, and prognosis of the tumor are discussed.
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8/10. 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.
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9/10. Osteoid osteomas and osteoblastomas of the spine.

    Benign osteoblastic lesions are rare bone tumors and they are usually divided into osteoid osteomas and benign osteoblastomas based on their biological behavior. Both lesions are prevalent in the spine, with the lamina and pedicle being involved frequently. Long diagnostic delays are frequent. Pain, the most prominent symptom, is often nocturnal and is relieved by aspirin in 30 to 40% of patients. Radicular pain occurs in 50% of the patients. The most common physical finding is tenderness in the vicinity of the lesion. Neurological abnormalities are more frequent in patients with osteoblastomas, which frequently extend into the neural canal. Tomograms are invaluable in most patients in whom plain films are normal. The bone scan is one of the most important diagnostic studies and provides an excellent means of accurately demonstrates the location and extent of the tumor. Permanent relief of pain and neurological recovery is dependent primarily on total removal of the lesion.
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10/10. Osteoid osteoma of the lateral cuneiform bone.

    An unusual case of osteoid osteoma is reported emphasizing the necessity of a careful history and physical examination combined with an adequate imaging supply. Treatment was surgical with an en bloc excision of the lesion.
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