+ Site Statistics
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Osteoid Osteoma of the Upper Extremity

Osteoid Osteoma of the Upper Extremity

Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca 86(1): 77-82

PURPOSE OF THE STUDY Osteoid osteoma (OO) of the upper extremity is a rare pathology representing a major diagnostic challenge. The patients are often times incorrectly treated due to a misdiagnosis and therefore the final management of symptoms is delayed by several months. During this time the pain, which is the main symptom, increases. The surgical treatment is a fast and efficient solution. This paper aims to highlight the specificity of the OO of the upper extremity, evaluate our study group, the time to diagnosis and the benefits of individual imaging techniques. MATERIAL AND METHODS In the period 2007-2017, a total of 8 patients with a histologically verified OO of the upper extremity were consulted and treated at the authors departments. The group of patients was retrospectively evaluated based on the medical reports, surgical protocols, imaging examinations, histology results of preoperative samples and a postoperative questionnaire. Pain was assessed on the Visual Analogue Scale (VAS) preoperatively, at 2 weeks, 2 months and at one year postoperatively and in January 2018. The mean follow-up period was 48 months (range 16-78). The presence of swelling, synovitis and a limited range of motion were clinically assessed. The removed tissue was tested in an accredited biopsy laboratory. RESULTS 8 patients with OO of the elbow, wrist and hand were treated in the period 2007-2017. In 5 cases the OO was located in the wrist (scaphoid, 2x trapezoid, hamate and capitate) and in 2 cases in finger phalanges (middle and distal phalanx). The mean age of the patients was 24.5 years (median 21.5, range 18-42). The male to female ratio was 7:1. The mean interval between the onset of symptoms and the final diagnosis was 16.25 months (median 15.5, range 12-25). The CT examination proved to be the most beneficial imaging techniques. A plain radiograph led to a diagnosis in 1 case only. The preoperative mean pain VAS value 9.25 dropped to VAS 1 at two weeks after the surgery. No recurrence was reported. DISCUSSION The main challenge in treating the OO of the upper extremity is the diagnosis. Despite of the availability of advanced imaging techniques, the interval from the onset of symptoms to correct diagnosis did not change over the past decades. As to the treatment, despite the development of new procedures the method of choice continues to be the surgical excochleation. CONCLUSIONS Osteoid osteoma of the upper extremity is a rare pathology which shall be considered in case of an increasing pain, especially in young men. A plain radiograph of the anatomically complex terrain of the hand and wrist is mostly not useful in diagnosis, whereas the CT examination can visualise even a small size nidus. The surgical excochleation results in pain relief and early functional recovery with swelling disappearance. To diagnose the OO is not difficult provided we take it into consideration. Key words:osteoid osteoma, upper extremity, hand, wrist, diagnosis.

(PDF emailed within 1 workday: $29.90)

Accession: 066565171

Download citation: RISBibTeXText

PMID: 30843518

Related references

Osteoid osteoma of the upper extremity. Hand Clinics 11(2): 211-221, 1995

Osteoid osteoma of the upper extremity. Journal of Hand Surgery 18(6): 1019-1025, 1993

Osteoid osteoma of the upper extremity of the femur. Revue de Chirurgie Orthopedique et Reparatrice de l'Appareil Moteur 72 Suppl 2: 101-103, 1986

Osteoid osteoma of the upper extremity. A diagnostic challenge. Chirurgie de la Main 25(2): 69-76, 2006

Radiofrequency ablation of osteoid osteoma in the upper extremity. Journal of Hand Surgery 31(2): 279-283, 2006

Osteoid osteoma of the lower extremity. Chirurgia Narzadow Ruchu i Ortopedia Polska 63(4): 363-371, 1998

Is osteoid osteoma an iodophilic lesion?: pathologically proved osteoid osteoma of nasal bone first seen on whole-body iodine-131 scan. Clinical Nuclear Medicine 28(8): 696-698, 2003

Osteoid osteoma treated with radiofrequency ablation in non-operating room anesthesia. A different way of approaching ablative therapy on osteoid osteoma. European Review for Medical and Pharmacological Sciences 22(17): 5438-5446, 2018

Osteoid osteoma and osteoid osteoma-mimicking lesions: biopsy findings, distinctive MDCT features and treatment by radiofrequency ablation. European Radiology 20(10): 2439-2446, 2011

A case of osteoid osteoma of the trapezoid bone: the efficiency of dynamic magnetic resonance imaging for the detection of osteoid osteoma localized at the atypical site. Hand Surgery 17(1): 99-103, 2012

Intra-articular osteoid osteoma of the lower extremity: diagnostic problems. Foot and Ankle International 23(3): 264-267, 2002

CT-guided radiofrequency ablation of osteoid osteoma in the long bones of the lower extremity. World Journal of Radiology 4(6): 278-282, 2012

Osteoid osteoma in the lower extremity of the radius: about a case, rare location and review of the literature. Pan African Medical Journal 24: 46, 2017

Osteoid osteoma of the upper maxilla. Acta Stomatologica Belgica 67(1): 139, 1970

Osteoid-Osteoma of Upper End of Ulna. Proceedings of the Royal Society of Medicine 40(9): 487-488, 1947