Archives of Orthopaedic and Trauma Surgery

, Volume 126, Issue 10, pp 660–667

Intra- and juxta-articular osteoid osteoma: a diagnostic challenge

Misdiagnosis and successful treatment: a report of four cases
  • Francesco Franceschi
  • Andrea Marinozzi
  • Rocco Papalia
  • Umile Giuseppe Longo
  • Gianfranco Gualdi
  • Enzo Denaro
Orthopaedic Surgery
  • 190 Downloads

Abstract

Osteoid osteoma is a benign tumour in young adults. The clinical manifestations are generally typical nocturnal pain that prevents sleep and that is alleviated with aspirin. When the typical clinical and radiological features are present, diagnosis is not difficult. Problems in the differential diagnosis may arise in connection with an unusual location. We report on the clinical features, radiographic and histopathological findings, treatment, and results of four patients who were managed for an intra- or juxta-articular osteoid osteoma at our medical centre between 2000 and 2002 and in whom the initial diagnosis was erroneous and delayed from 1 to 10 years. In order to remove these lesions, we performed a CT-guided en block retrograde resection under arthroscopic control for juxta-articular osteoid osteomas (knee) and an arthroscopy-assisted en block antegrade resection in two cases of intra-articular osteoid osteoma (elbow and shoulder). None of the osteoid osteomas recurred in the follow-up period, and each patient got relief from pain.

Keywords

Intra-articular Juxta-articular Osteoid osteoma Arthroscopy En block resection 

References

  1. 1.
    Ambrosia JM, Kernek CB (1985) Osteoid osteoma of the foot: presentation following trauma. Orthopedics 8:684–685PubMedGoogle Scholar
  2. 2.
    Assoun J, Richardi G, Railhac JJ, Baunin C, Fajadet P, Giron J, Maquin P, Haddad J, Bonnevialle P (1994) Osteoid osteoma: MR imaging versus CT. Radiology 191:217–223PubMedGoogle Scholar
  3. 3.
    Corbett JM, Wilde AH, McCormack LJ, Evarts CM (1974) Intra-articular osteoid osteoma; a diagnostic problem. Clin Orthop Relat Res 98:225–230PubMedCrossRefGoogle Scholar
  4. 4.
    Cronemeyer RL, Kirchmer NA, De Smet AA, Neff JR (1981) Intra-articular osteoid-osteoma of the humerus simulating synovitis of the elbow. A case report. J Bone Joint Surg Am 63:1172–1174PubMedGoogle Scholar
  5. 5.
    Franceschi F, Marinozzi A, Rizzello G, Papalia R, Rojas M, Denaro V (2005) Computed tomography-guided and arthroscopically controlled en bloc retrograde resection of a juxta-articular osteoid osteoma of the tibial plateau. Arthroscopy 21:351–359PubMedCrossRefGoogle Scholar
  6. 6.
    Frassica FJ, Waltrip RL, Sponseller PD, Ma LD, McCarthy EF Jr (1996) Clinicopathologic features and treatment of osteoid osteoma and osteoblastoma in children and adolescents. Orthop Clin North Am 27:559–574PubMedGoogle Scholar
  7. 7.
    Freyschmidt I Ostertag H (1988) Knochenbildende Tumoren. In: Freyschmidt I, Ostertag H (eds) Knochentumoren. Springer, Berlin Heidelberg New York, pp 97–106Google Scholar
  8. 8.
    Georgoulis AD, Papageorgiou CD, Moebius UG, Rossis J, Papadonikolakis A, Soucacos PN (2002) The diagnostic dilemma created by osteoid osteoma that presents as knee pain. Arthroscopy 18:32–37PubMedCrossRefGoogle Scholar
  9. 9.
    Goldman AB, Schneider R, Pavlov H (1993) Osteoid osteomas of the femoral neck: report of four cases evaluated with isotopic bone scanning, CT, and MR imaging. Radiology 186:227–232PubMedGoogle Scholar
  10. 10.
    Healey JH, Ghelman B (1986) Osteoid osteoma: current concepts and recent advances. Clin Orthop 204:76–85PubMedGoogle Scholar
  11. 11.
    Helms CA, Hattner RS, Vogler JB 3rd (1984) Osteoid osteoma: radionuclide diagnosis. Radiology 151:779–784PubMedGoogle Scholar
  12. 12.
    Jaffe HL (1935) Osteoid osteoma of bone. Radiology 45:319Google Scholar
  13. 13.
    Jaffe Hl (1953) Osteoid-osteoma. Proc R Soc Med 46:1007–1012PubMedGoogle Scholar
  14. 14.
    Joyce MJ, Mankin HJ (1983) Caveat arthroscopos: extra-articular lesions of bone simulating intra-articular pathology of the knee. J Bone Joint Surg Am 65:289–292PubMedGoogle Scholar
  15. 15.
    Kaempffe FA (1994) Osteoid osteoma of the coracoid process. Excision by posterior approach. A case report. Clin Orthop Relat Res 301:260–262PubMedGoogle Scholar
  16. 16.
    Kendrick JI, Evarts CM (1967) Osteoid-osteoma: a critical analysis of 40 tumors. Clin Orthop Relat Res 54:51–59PubMedGoogle Scholar
  17. 17.
    Khurana JS, Mayo-Smith W, Kattapuram SV (1990) Subtalar arthralgia caused by juxtaarticular osteoid osteoma. Clin Orthop Relat Res 252:205–208PubMedGoogle Scholar
  18. 18.
    Kiers L, Shield LK, Cole WG (1990) Neurological manifestations of osteoid osteoma. Arch Dis Child 65:851–855PubMedCrossRefGoogle Scholar
  19. 19.
    Kransdorf MJ, Stull MA, Gilkey FW, Moser RP Jr (1991) Osteoid osteoma. Radiographics 11:671–696PubMedGoogle Scholar
  20. 20.
    Marcove RC, Freiberger RH (1966) Osteoid osteoma of the elbow–a diagnostic problem. Report of four cases. J Bone Joint Surg Am 48:1185–1190PubMedGoogle Scholar
  21. 21.
    Moberg E (1951) The natural course of osteoid osteoma. J Bone Joint Surg Am 33:166–170PubMedGoogle Scholar
  22. 22.
    Pikoulas C, Mantzikopoulos G, Thanos L, Passomenos D, Dalamarinis C, Glampedaki-Dagianta K (1995) Unusually located osteoid osteomas. Eur J Radiol 20:120–125PubMedCrossRefGoogle Scholar
  23. 23.
    Roberts P, Davies AM, Starkie CM, Grimer RJ (1990) The nidus of an osteoid osteoma mimicking an os supratrochleare dorsale. Br J Radiol 63:899–902PubMedCrossRefGoogle Scholar
  24. 24.
    Sim FH, Dahlin DC, Beabout JW (1975) Osteoid-osteoma: diagnostic problems. J Bone Joint Surg Am 57:154–159PubMedGoogle Scholar
  25. 25.
    Snarr JW, Abell MR, Martel W (1973) Lymphofollicular synovitis with osteoid osteoma. Radiology 106:557–560PubMedGoogle Scholar
  26. 26.
    Torg JS, Loughran T, Pavlov H, Schwamm H, Gregg J, Sherman M, Balduini FC (1985) Osteoid osteoma. Distant, periarticular, and subarticular lesions as a cause of knee pain. Sports Med 2:296–304PubMedGoogle Scholar
  27. 27.
    Yamamura S, Sato K, Sugiura H, Asano M, Takahashi M, Iwata H (1994) Magnetic resonance imaging of inflammatory reaction in osteoid osteoma. Arch Orthop Trauma Surg 114:8–13PubMedCrossRefGoogle Scholar
  28. 28.
    Winter PF, Johnson PM, Hilal SK, Feldman F (1977) Scintigraphic detection of osteoid osteoma. Radiology 122:177–178PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Francesco Franceschi
    • 1
  • Andrea Marinozzi
    • 1
  • Rocco Papalia
    • 1
  • Umile Giuseppe Longo
    • 1
  • Gianfranco Gualdi
    • 2
  • Enzo Denaro
    • 1
  1. 1.Department of Orthopaedic and Trauma SurgeryCampus Biomedico UniversityRomeItaly
  2. 2.Department of RadiologyPoliclinico Umberto I UniversityRomeItaly

Personalised recommendations