Abstract
Objectives
We performed a retrospective review of the imaging of nine patients with a diagnosis of foot osteoid osteoma (OO).
Materials and methods
Radiographs, computed tomography (CT) and magnetic resonance imaging (MRI) had been performed in all patients. Radiographic features evaluated were the identification of a nidus and cortical thickening. CT features noted were nidus location (affected bone—intramedullary, intracortical, subarticular) and nidus calcification. MRI features noted were the presence of an identifiable nidus, presence and grade of bone oedema and whether a joint effusion was identified.
Results
Of the nine patients, three were female and six male, with a mean age of 21 years (range 11–39 years). Classical symptoms of OO (night pain, relief with aspirin) were identified in five of eight (62.5%) cases (in one case, the medical records could not be retrieved). In five patients the lesion was located in the hindfoot (four calcaneus, one talus), while four were in the mid- or forefoot (two metatarsal and two phalangeal). Radiographs were normal in all patients with hindfoot OO. CT identified the nidus in all cases (89%) except one terminal phalanx lesion, while MRI demonstrated a nidus in six of nine cases (67%). The nidus was of predominantly intermediate signal intensity on T1-weighted (T1W) sequences, with intermediate to high signal intensity on T2-weighted (T2W) sequences. High-grade bone marrow oedema, limited to the affected bone and adjacent soft tissue oedema was identified in all cases.
Conclusions
In a young patient with chronic hindfoot pain and a normal radiograph, MRI features suggestive of possible OO include extensive bone marrow oedema limited to one bone, with a possible nidus demonstrated in two-thirds of cases. The presence or absence of a nidus should be confirmed with high-resolution CT.
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References
Saifuddin A. Musculoskeletal MRI. 1st ed. London: Hodder Arnold; 2008. pp. 700–701.
Freiberger RH, Loitman BS, Halpern M, Thompson TC. Osteoid osteoma. A report of 80 cases. AJR Am J Roentgenol. 1959;82:194–205.
Jackson RP, Reckling FW, Mantz FA. Osteoid osteoma and osteoblastoma. Similar histological lesions with different natural histories. Clin Orthop Relat Res. 1977;128:303–31.
Casadei R, Ferraro A, Ferruzzi A, Biagini R, Ruggieri P. Bone tumours of the foot: epidemiology and diagnosis. Chir Organi Mov. 1991;76:47–62.
Zouari L, Bousson V, Hamze B, Roulot E, Roqueplan F, Laredo JD. CT-guided percutaneous laser photo-coagulation of osteoid osteomas of the hands and feet. Eur Radiol. 2008;18:2635–41.
Ehara S, Rosenthal DI, Aoki J, et al. Peritumoral oedema in osteoid osteoma on magnetic resonance imaging. Skeletal Radiol. 1999;28:265–70.
Jaffe HL. Osteoid osteoma of bone. Radiology. 1935;45:319.
Healey JH, Ghelman B. Osteoid osteoma: current concepts and recent advances. Clin Orthop. 1986;204:76–85.
Resnick D, Niwayama G. Tumors and tumor-like lesions of bone: imaging and pathology of specific lesions. In: Resnick D, Kyriakos M, Greenway G, editors. Diagnosis of bone and joint disorders. 2nd ed. Philadelphia: Saunders; 1988.
Brabants K, Geens S, van Damme B. Subperiosteal juxta-articular osteoid osteoma. J Bone Joint Surg Br. 1986;68:320–4.
Snarr JW, Abell MR, Martel W. Lymphofollicular synovitis with osteoid osteoma. Radiology. 1973;106:557–60.
Sim FH, Dahlin CD, Beabout JW, et al. Osteoid osteoma: diagnostic problems. J Bone Joint Surg Am. 1975;57:154–9.
Panni AS, Maiotti M, Burke J. Osteoid osteoma of the neck of talus. Am J Sports Med. 1989;17:584–8.
Pai V, Pai VS. Osteoid osteoma of the talus: a case report. J Orthop Surg (Hong Kong). 2008;16:260–2.
Sanhudo JA. Osteoid osteoma of the calcaneus mimicking os trigonum syndrome: a case report. Foot Ankle Int. 2006;27:548–51.
Monroe MT, Manoli A 2nd. Osteoid osteoma of the lateral talar process presenting as a chronic sprained ankle. Foot Ankle Int. 1999;20:461–3.
Barca F, Acciaro AL, Recchioni MD. Osteoid osteoma of the phalanx: enlargement of the toe- two case reports. Foot Ankle Int. 1998;19:388–93.
Temple HT, Vinh TN, Mizel M. Intra-articular osteoid osteoma as a cause of chronic ankle pain. Foot Ankle Int. 1998;19:384–7.
Chuang SY, Wang SJ, Au MK, Huang GS. Osteoid osteoma in the talar neck: a report of two cases. Foot Ankle Int. 1998;19:44–7.
Snow Sw, Sobel M, DiCarlo EF, Thompson FM, Deland JT, et al. Chronic ankle pain caused by osteoid osteoma of the neck of the talus. Foot Ankle Int. 1997;18:98–101.
Resnick RB, Jarolem KL, Sheskier SC, Desai P, Cisa J. Arthroscopic removal of an osteoid osteoma of the talus: a case report. Foot Ankle Int. 1995;16:212–5.
Trettin DM, Browne JE. Osteoid osteoma of the tarsal cuboid presenting with recurrent ankle sprains in an adolescent: a case report. Foot Ankle Int. 1995;16:30–33.
Hosalkar HS, Garg S, Moroz L, Pollack A, Dormans JP. The diagnostic accuracy of MRI versus CT imaging for osteoid osteoma in children. Clin Orthop Relat Res. 2005;433:171–7.
Gamba JL, Martinez S, Apple J, Harrelson JM, Nunley JA. Computed tomography of axial skeletal osteoid osteoma. AJR Am J Roentgenol. 1984;142:769–77.
Shereff MJ, Cullivan WT, Johnson KA. Osteoid Osteoma of the foot. J Bone Joint Surg Am. 1983;65-A:638–41.
Zampa V, Bargellini I, Ortori S, Faggioni L, Cioni R, Bartolozzi C. Osteoid osteoma in atypical locations: the added value of dynamic gadolinium-enhanced MR imaging. Eur J Radiol. 2008;Epub ahead of print.
Davies M, Cassar-Pullicino VN, Davies AM, McCall IW, Tyrell PN. The diagnostic accuracy of MRI findings in osteoid osteoma. Skeletal Radiol. 2002;31:559–69.
Nogues P, Marti-Bonmati L, Aparisi F, Saborido MC, Garci J, Dosda R. MR imaging assessment of juxta cortical oedema in osteoid osteoma in 28 patients. Eur Radiol. 1998;8:236–8.
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Shukla, S., Clarke, A.W. & Saifuddin, A. Imaging features of foot osteoid osteoma. Skeletal Radiol 39, 683–689 (2010). https://doi.org/10.1007/s00256-009-0737-3
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DOI: https://doi.org/10.1007/s00256-009-0737-3