Comparative study of orthopaedic robot-assisted minimally invasive surgery and open surgery for limb osteoid osteoma / 中国修复重建外科杂志

OBJECTIVE@#To compare the accuracy and effectiveness of orthopaedic robot-assisted minimally invasive surgery versus open surgery for limb osteoid osteoma.@*METHODS@#A clinical data of 36 patients with limb osteoid osteomas admitted between June 2016 and June 2023 was retrospectively analyzed. Among them, 16 patients underwent orthopaedic robot-assisted minimally invasive surgery (robot-assisted surgery group), and 20 patients underwent tumor resection after lotcated by C-arm X-ray fluoroscopy (open surgery group). There was no significant difference between the two groups in the gender, age, lesion site, tumor nidus diameter, and preoperative pain visual analogue scale (VAS) scores ( P>0.05). The operation time, lesion resection time, intraoperative blood loss, intraoperative fluoroscopy frequency, lesion resection accuracy, and postoperative analgesic use frequency were recorded and compared between the two groups. The VAS scores for pain severity were compared preoperatively and at 3 days and 3 months postoperatively.@*RESULTS@#Compared with the open surgery group, the robot-assisted surgery group had a longer operation time, less intraoperative blood loss, less fluoroscopy frequency, less postoperative analgesic use frequency, and higher lesion resection accuracy ( P<0.05). There was no significant difference in lesion resection time ( P>0.05). All patients were followed up after surgery, with a follow-up period of 3-24 months (median, 12 months) in the two groups. No postoperative complication such as wound infection or fracture occurred in either group during follow-up. No tumor recurrence was observed during follow-up. The VAS scores significantly improved in both groups at 3 days and 3 months after surgery when compared with preoperative value ( P<0.05). The VAS score at 3 days after surgery was significantly lower in robot-assisted surgery group than that in open surgery group ( P<0.05). However, there was no significant difference in VAS scores at 3 months between the two groups ( P>0.05).@*CONCLUSION@#Compared with open surgery, robot-assisted resection of limb osteoid osteomas has longer operation time, but the accuracy of lesion resection improve, intraoperative blood loss reduce, and early postoperative pain is lighter. It has the advantages of precision and minimally invasive surgery.

Short-term effectiveness of orthopedic robot-assisted resection for osteoid osteoma / 中国修复重建外科杂志

OBJECTIVE@#To investigate short-term effectiveness and clinical application advantages of orthopedic robot-assisted resection for osteoid osteoma compared with traditional open surgery.@*METHODS@#A retrospective analysis was conducted on clinical data of 48 osteoid osteoma patients who met the selection criteria between July 2022 and April 2023. Among them, 23 patients underwent orthopedic robot-assisted resection (robot-assisted surgery group), and 25 patients received traditional open surgery (traditional surgery group). There was no significant difference ( P>0.05) in gender, age, disease duration, lesion location and size, and preoperative visual analogue scale (VAS) score, and musculoskeletal tumor society (MSTS) score between the two groups. The surgical time, intraoperative blood loss, intraoperative lesion localization time, initial localization success rate, infection, and recurrence were recorded and compared. VAS scores before surgery and at 24 hours, 1, 3, 6, and 9 months after surgery and MSTS score before surgery and at 3 months after surgery were assessed.@*RESULTS@#All patients completed the surgery successfully, with no significant difference in surgical time between the two groups ( P>0.05). Compared to the traditional surgery group, the robot-assisted surgery group had less intraoperative blood loss, shorter lesion localization time, and shorter hospitalization time, with significant differences ( P<0.05). The initial localization success rate was higher in the robot-assisted surgery group than in the traditional surgery group, but the difference between the two groups was not significant ( P>0.05). All patients in both groups were followed up, with the follow-up time of 3-12 months in the robot-assisted surgery group (median, 6 months) and 3-14 months in the traditional surgery group (median, 6 months). The postoperative MSTS scores of both groups improved significantly when compared to those before surgery ( P<0.05), but there was no significant difference in the changes in MSTS scores between the two groups ( P>0.05). The postoperative VAS scores of both groups showed a gradually decreasing trend over time ( P<0.05), but there was no significant difference between the two groups after surgery ( P>0.05). During follow-up, except for 1 case of postoperative infection in the traditional surgery group, there was no infections or recurrences in other cases. There was no significant difference in the incidence of postoperative infection between the two groups ( P>0.05).@*CONCLUSION@#Orthopedic robot-assisted osteoid osteoma resection achieves similar short-term effectiveness when compared to traditional open surgery, with shorter lesion localization time.

Resección de osteoma osteoide vertebral asistida por planificación 3D. Presentación de un caso / Resection of spinal osteoid osteoma assisted by 3D planning. Case report

La localización vertebral de una lesión compatible con un osteoma osteoide requiere, muchas veces, su resección en bloque mar-ginal mediante cirugía. El objetivo de este artículo es informar sobre el uso de la tecnología en impresión 3D para desarrollar guías de corte y así lograr una resección segura y completa de un osteoma osteoide de L1. Presentamos a un varón de 13 años, operado de un osteoma osteoide de L1 y detallamos la planificación preoperatoria con asistencia de la tecnología 3D, la técnica quirúrgica mediante guías de corte impresas y un modelo real de la columna lumbar y el control posoperatorio. Conclusiones: Ante la indicación de cirugía para una lesión compatible con osteoma osteoide en la columna debe decidirse entre la posibilidad de resección intralesional abierta o percutánea y la resección marginal en bloque. Para localizar la lesión durante la cirugía, se utilizan diferentes métodos. En nuestro Servicio, estamos utilizando la tecnología 3D para la planificación preoperatoria de múltiples enfermedades traumatológicas agudas y las secuelas. Esto nos permite una mayor precisión y seguridad en la identificación de los márgenes de resección intraoperatoria, reduciendo, al mínimo, la extracción de tejidos sanos y evitando la inestabilidad posoperatoria. Nivel de Evidencia: IV

The vertebral location of a lesion compatible with an osteoid osteoma often requires a marginal en bloc resection. Our objective is to present the use of 3D printing technology for the development of specific cutting guides that achieve a safe and complete resection of an L1 osteoid osteoma. We present the case of a 13-year-old male who underwent surgery for an L1 osteoid osteoma, de-tailing the preoperative planning assisted by 3D technology, the surgical technique using 3D printed cutting guides, a real model of the lumbar spine, and the postoperative control. Conclusion: Before the surgical indication of a lesion compatible with an osteoid osteoma in the spine, we must decide between the possibility of an open intralesional resection or percutaneous and marginal en bloc resection. Different methods can be used for the intraoperative location of the lesion. In our department, we use 3D technology for preoperative planning of multiple acute and post-traumatic pathologies. This allows us to be precise and safe in the identification of intraoperative resection margins, minimizing the removal of healthy tissues and avoiding postoperative instability. Level of Evidence: IV

Repercusión biomecánica derivada de un osteoma en el tercio proximal del fémur: a propósito de un caso / Biomechanical Impact Derived From an Osteoma in the Proximal Third of the Femur: Report of a Case

Introducción: El osteoma osteoide es un tumor óseo benigno, que no tiene potencial de crecimiento por lo que su tamaño no supera 1,5 cm pese a que la esclerosis que lo rodea le da un aspecto mayor. Afecta con mayor frecuencia a los varones jóvenes, y la mayoría de las veces aparece en las tres primeras décadas de la vida. Objetivos: Mostrar las repercusiones biomecánicas derivadas de un osteoma osteoide en el trayecto de la cintilla iliotibial y sus influencias por cadenas musculares descendentes sobre el miembro inferior. Presentación del caso: Se presenta una paciente de 24 años que acude a la consulta por presentar dolor a nivel de la cara externa del fémur derecho desde hace dos años; que se agudiza fundamentalmente con la marcha. Tras realizar las pertinentes exploraciones y pruebas diagnósticas por imagen, no se observan hallazgos clínicos significativos, por tanto se pauta tratamiento antiinflamatorio por vía oral y se efectúa estudio biomecánico y postural en el cual se detecta pie valgos bilaterales, inestables, con mayor relevancia en el pie derecho. La paciente acude nuevamente al no encontrar mejoría, se realiza telemetría del miembro inferior y resonancia magnética del fémur derecho. La imagen para diagnóstico da como resultado la presencia de una masa compatible con un osteoma osteoide de 11 x 4 mm en el tercio proximal lateral del fémur derecho. Conclusiones: Una lesión neoplásica que afecte al trayecto de un grupo muscular con repercusión biomecánica puede realizar compensaciones a diferentes niveles, por tanto, es necesaria la actuación de un equipo multidisciplinario para restablecer la marcha. Las sinergias entre el tratamiento conservador y quirúrgico provocan un mayor porcentaje de éxito(AU)

Introduction: Osteoid osteoma is a benign bone tumor, which has no growth potential, consequently its size does not exceed 1.5 cm despite the fact that the surrounding sclerosis gives it a larger appearance. It most often affects young men, most often appearing in the first three decades of life. Objectives: To show the biomechanical repercussions derived from an osteoid osteoma in the trajectory of the iliotibial band and its influences by descending muscle chains on the lower limb. Case report: We report a 24-year-old female patient who came to the consultation due to pain on the external face of her right femur for two years. This pain worsened mainly by walking. After carrying out the pertinent explorations and diagnostic imaging tests, no significant clinical findings were observed, therefore, oral anti-inflammatory treatment was prescribed and biomechanical and postural study was carried out, which showed bilateral, unstable valgus foot, with higher relevance on the right foot. The patient came again when she had no improvement, telemetry of her lower limb and magnetic resonance imaging of her right femur were performed. The diagnostic image revealed the presence of a mass compatible with an 11 x 4 mm osteoid osteoma in the proximal lateral third of her right femur. Conclusions: A neoplastic lesion that affects the trajectory of a muscle group with biomechanical repercussions can carry out compensations at different levels, therefore, the action of a multidisciplinary team is necessary to restore gait. Synergies between conservative and surgical treatment lead to a higher success rate(AU)

Osteoma osteoide: causa poco frecuente de dolor crónico en la muñeca en una niña / Osteoid osteoma: unusual cause of chronic pain in the wrist in a child

El osteoma osteoide es una lesión ósea benigna que, habitualmente, se acompaña de clínica típica caracterizada por dolor nocturno que mejora con antiinflamatorios no esteroideos. Aunque la presentación clínica es típica, con frecuencia, es común la demora diagnóstica, en especial, en los casos con localización atípica.Se presenta el caso de una paciente de 10 años con dolor en la muñeca izquierda de dos años de evolución con diagnóstico de osteoma osteoide localizado en el hueso grande del carpo. La localización atípica de la lesión conllevó un retraso diagnóstico importante

Osteoid osteoma is a benign bone lesion that is usually accompanied by a typical clinical condition characterized by night pain that improves with non-steroidal anti-inflammatory drugs. Although the clinical presentation is frequently typical, diagnostic delay is common, especially in cases with an atypical location.We report the case of a 10-year-old patient with left wrist pain of two years of evolution with diagnosis of osteoid osteoma located in capitate bone. The atypical location of the lesion led to a significant diagnostic delay.

Osteoma osteoide de falange. Reporte de cinco casos y revisión bibliográfica / Phalanx osteoid osteoma. Five-case report and literature review

Introducción: El osteoma osteoide de falange es un cuadro infrecuente. El objetivo de este artículo es presentar cinco pacientes con diagnóstico histopatológico de osteoma osteoide de falange y resaltar los aspectos más relevantes del diagnóstico y el tratamiento. Materiales y Métodos: Estudio descriptivo, retrospectivo. Se evaluaron el dolor, según la escala analógica visual, la movilidad activa y el puntaje QuickDASH antes de la cirugía y en el control final a los 35.4 meses. Resultados: El tiempo medio desde la primera consulta hasta el diagnóstico fue de 10.6 meses (rango 5-16). El puntaje QuickDASH medio preoperatorio fue de 22,72 (rango 6,8-40,9). Luego del seguimiento medio de 35.4 meses (rango 17-63), todos los pacientes estaban satisfechos con el resultado. El puntaje medio de dolor fue 0. El puntaje QuickDASH medio fue 0. Conclusiones: El osteoma osteoide debe pensarse como diagnóstico diferencial ante un paciente que consulta por dolor digital subagudo o crónico que cede con antinflamatorios no esteroides. El tratamiento quirúrgico mediante el curetaje simple o la resección en bloque logra resultados satisfactorios. Sin embargo, como su prevalencia es baja, se suele pasar por alto y así se retrasan el diagnóstico y el tratamiento. Nivel de Evidencia; IV

Introduction: Osteoid osteomas are rarely found in the phalanges. The purpose of this study is to report 5 cases with histologic diagnosis of phalanx osteoid osteoma and highlight the most important aspects of its diagnosis and treatment. Materials and Methods: A descriptive, retrospective study was conducted. Evaluation included pain level using the visual analog scale (VAS), active range of motion, and QuickDASH score before surgery and at final follow-up (mean, 35.4 months). Results: The mean time from first consultation to diagnosis was 10.6 months (range, 5-16 months). The mean preoperative QuickDASH score was 22.72 (range, 6.8-40.9). At last follow-up (mean, 35.4 months; range, 17-63), all patients were satisfied with the outcome. The mean VAS score for pain was 0. The mean QuickDASH score was 0. Conclusions: Osteoid osteoma should be considered in the differential diagnosis when patients complain of subacute or chronic digital pain that improves with NSAIDs. Surgical treatment by simple curettage or en bloc resection shows satisfactory results. However, due to its low prevalence, osteoid osteoma is commonly underdiagnosed resulting in diagnosis and treatment delays. Level of Evidence; IV

Resection of Bone Tumor Guided by Gamma Probe and Evaluation of Postoperative Pain / Ressecção de tumor ósseo guiado por Gamaprobe e avaliação do quadro álgico pós-operatório

Abstract Osteoid osteoma is a benign neoplasm commonly found in young men, but that can be found in every age, which affects mainly long bones, clinically characterized by continuous and limiting pain that is relieved by salicylates. It is a small lesion composed of immature osteoid tissue, central hypervascularization and surrounding sclerotic area. Its diagnosis is performed by the clinic and aided by imaging tests, such as common radiography and computed tomography. Radiography shows a central radiolucent lesion and peripheral sclerosis. The biopsy takes place only in cases of diagnostic doubt. Surgical treatment involves resection of the niche, providing greater symptomatic relief, as well as percutaneous techniques. The technique of radioisotope-guided resection has good acceptance in the scientific community for its fast surgical procedure directed to the lesion; however, the percutaneous technique that stands out is radiofrequency ablation. In the present study, all of the patients submitted to the technique presented total improvement of the pain.

Resumo O osteoma osteóide é uma neoplasia benigna comum em homens jovens; porém, pode atingir qualquer idade, acomete preferencialmente ossos longos, e é caracterizada por dor contínua e limitante que é aliviada por salicilatos. É uma lesão de tamanho pequeno, composta por tecido osteóide imaturo, hipervascularização central e área esclerótica circundante. O diagnóstico é realizado pela clínica e auxiliado por exames de imagem, como radiografia comum e tomografia computadorizada. À radiografia, apresenta-se como uma lesão radiolucente central e esclerose periférica. A biópsia está indicada somente nos casos de dúvida diagnóstica. O tratamento cirúrgico envolve a ressecção do nicho, proporcionando maior alívio sintomático, assim como as técnicas percutâneas. A técnica de ressecção guiada por radioisótopo tem boa aceitação na comunidade científica por tornar o procedimento cirúrgico mais rápido e dirigido para a lesão, ainda que o padrão ouro de tratamento seja a técnica percutânea de ablação por radiofrequência. É válido ressaltar que, no presente estudo, todos os pacientes submetidos à resecção cirúrgica apresentaram regressão do quadro álgico.

Limb Length Discrepancy on an 11-Month-Old Boy with Osteoid Osteoma / Discrepância de membros em menino de 11 meses de idade associada a osteoma osteoide

Abstract Osteoid osteoma is a benign bone tumor that frequently occurs between the ages of 10 and 25 years old; in about 80% of the patients, it is associated with intense pain. The present article describes the case of an 11-month-old infant with claudication, right lower limb shortening, and painless right leg volume increase. Image studies demonstrated an osteolytic lesion with small ossifications within, involved by cortical thickening of the right tibial diaphysis. The diagnostic hypotheses were osteoid osteoma, chronic osteomyelitis (Brodie abscess), Ewing sarcoma, and Langerhans cell histiocytosis. Microorganismcultures were negative and the histopathological exam demonstrated osteoid osteoma. The present report expands the knowledge on osteoid osteoma as a cause of painless limping and lower limb shortening in infancy. The early differential diagnosis is important, as surgical excision is curative and prevents further complications.

Resumo Osteoma osteoide é umtumor ósseo benigno,mais frequentedos 10aos 25anos de idadee, em cerca de 80% dos pacientes, está associado a dor forte. O presente artigo descreve um pacientemasculino apresentando claudicação, encurtamento domembro inferior direito e aumento de volume indolor da perna direita desde os 11 meses de idade. Os exames de imagem demonstraram lesão osteolítica contendo pequenas ossificações de permeio, envolvidas por espessamento cortical da diáfise da tíbia direita. As hipóteses diagnósticas de osteoma osteoide, de osteomielite crônica (abscesso de Brodie), de sarcoma de Ewing e de histiocitose de células de Langerhans foram levantadas. As culturas para microrganismos foram negativas e o exame histopatológico demonstrou osteoma osteoide. O presente relato expande o conhecimento sobre osteoma osteoide como causa de claudicação e discrepância demembros inferiores indolor emlactente.Odiagnóstico diferencial precoce é importante, pois a exérese da lesão é curativa e previne sequelas futuras.

Tratamiento artroscópico del osteoma osteoide en el astrágalo / Arthroscopic treatment of osteoid osteoma in the talus

Introducción: El osteoma osteoide (OO) es el tumor osteoblástico benigno más frecuente. La ubicación en el astrágalo es del 2 al 10%. La resección es la única opción curativa. Presentamos una serie de 2 casos de osteoma osteoide en cuello del astrágalo con resección artroscópica y radiofrecuencia como tratamiento. Material y Métodos: Presentamos dos pacientes de 23 y 24 años, con dolor crónico en tobillo e imágenes por tomografía y resonancia compatibles con osteoma osteoide. Resultados: Los pacientes evolucionaron favorablemente, con una mejoría notable del score AOFAS, recuperación completa del cuadro y sin recidivas a los 18 meses de seguimiento. Discusión: El diagnóstico suele ser tardío, siendo el primer síntoma el dolor de predominio nocturno y que alivia con el uso de salicilatos. La extirpación artroscópica del OO del tobillo puede ser un procedimiento exitoso con mínimas complicaciones, siendo el tumor fácil de localizar y visualizar. Conclusión: Obtuvimos resultados satisfactorios para el paciente, con tiempos de recuperación breves y menor riesgo de infección. El procedimiento muy recomendable. Tipo de estudio: Serie de casos. Nivel de Evidencia: V

Introduction: Osteoid osteoma (OO) is the most frequent benign osteoblastic tumor. The location in the talus is 2 to 10%. Resection is the only curative option. We present arthroscopic resection and use of radiofrequency as treatment. Material and methods: We present two patients aged 23 and 24 years, with chronic ankle pain, computed tomography and magnetic resonance images compatible with osteoid osteoma. Results: Patients showed complete recovery after procedures, with an notable improvement of AOFAS and no recurrence after a follow-up of 18 months. Discussion: Late diagnosis is usually due to the first symptom being a pain, with nocturnal predominance and relieved by the use of salicylates. Arthroscopic removal of the OO of the ankle can be a successful procedure with minimal complications, being easy to locate and completely visualize the tumor. Conclusion: We obtained satisfactory postoperative results, with short recovery times and decreased risks of infection. We highly recommend the procedure. Type of study: Case series. Level of Evidence: V

Osteoid Osteoma of the Sacrum: A Case Report

STUDY DESIGN: Case report.OBJECTIVES: To report a case of osteoid osteoma arising in the sacrum in a 29-year-old male patient.SUMMARY OF LITERATURE REVIEW: Osteoid osteoma is a benign osteoblastic tumor that usually arises in the long bones. Osteoid osteoma involving the sacrum is extremely rare.MATERIALS AND METHODS: A 29-year-old male patient presented with pain localized in his sacral area for 10 months. His pain was worse at night, relieved by non-steroidal anti-inflammatory drugs, and independent of physical activity. Bone scintigraphy showed increased uptake in the second sacral vertebra (S2). Computed tomography revealed a nidus located in the S2 spinous process. Magnetic resonance imaging showed bone and soft tissue edema around the nidus.RESULTS: En bloc excision including the nidus revealed a diagnosis of osteoid osteoma and provided immediate relief of the patient's long-lasting sacral pain.CONCLUSIONS: When a young patient presents with localized sacral pain that is worse at night, relieved by non-steroidal anti-inflammatory drugs, independent of physical activity, and lasts longer than expected, proper imaging studies should be performed to rule out osteoid osteoma. Although less invasive treatment modalities have been introduced, classical en bloc excision is currently the gold standard for managing osteoid osteoma.

Arthroscopic Excision of Delayed Diagnosed Intra-articular Osteoid Osteoma of the Elbow: A Case Report

An intra-articular osteoid osteoma is a very rare cause of elbow pain, and its diagnosis and treatment remain challenging. Delayed diagnosis may lead to arthritic change of the joint. In this study, the authors present the occurrence of intra-articular osteoid osteoma in the right elbow of a 15-year-old male patient who presented with prolonged pain and limited motion owing to delayed diagnosis. After confirming the nidus of osteoid osteoma from radiographic evaluation, the lesion was completely removed arthroscopically. The patient presented a complete relief of symptoms and full range of motion. This is the first domestic report of successful arthroscopic treatment of an intra-articular osteoid osteoma of the elbow.

Osteoid osteoma - radiofrequency ablation treatment guided by computed tomography: a case series / Osteoma osteoide - Tratamento com radioablação guiada por tomografia computadorizada: uma série de casos

ABSTRACT The osteoid osteoma is a benign primary bone tumor that affects mainly males in the second and third decades of life. Radiographic findings show a radiolucent nidus surrounded by reactive sclerotic bone, particularly in the long bones of the lower extremity. Clinically, it presents persistent pain, which is worse at night and improves with salicylates. It can be a self-limiting injury, with an average duration of three years, but because of pain intensity and intolerance to prolonged use of nonsteroidal anti-inflammatories, surgical treatment is an option. The diagnosis is suspected according to the history and radiographic findings, and the confirmation is made by histological analysis. The traditional surgical treatment is the complete excision of the nidus, but some disadvantages have been described, such as difficulties in localizing the lesion and risk of fracture during the procedure, hospital stay for pain control, and unfavorable esthetic outcome. The authors report a series of cases treated with thermal radiofrequency ablation guided by computed tomography in this service. It is a safe and an effective percutaneous method that aims to cure, minimizing the trauma and morbidity when compared with the conventional block-resection method.

RESUMO O osteoma osteoide é um tumor ósseo primário benigno que acomete mais o sexo masculino na segunda e terceira décadas da vida. Radiograficamente, caracteriza-se por um nicho radiolucente cercado por osso esclerótico reativo, principalmente em ossos longos da extremidade inferior. Clinicamente, apresenta uma dor persistente de longa duração, com pioria noturna e melhoria com salicilatos. Embora possa ser uma lesão autolimitada, com duração média de três anos, a ressecção da lesão é uma opção de tratamento devido à intensidade da dor e intolerância ao uso prolongado de anti-inflamatórios não hormonais. Sua suspeita diagnóstica baseia-se principalmente na história clínica e nos achados radiográficos, a confirmação é feita pelo estudo anatomopatológico. O tratamento cirúrgico clássico é a excisão cirúrgica completa do nicho, porém são descritas desvantagens como a dificuldade para a localização intraoperatória da lesão, risco de fratura durante o procedimento, tempo de internação hospitalar para controle álgico e resultado estético desfavorável. Relatamos uma série de casos tratados com termoablação por radiofrequência guiada por tomografia computadorizada em nosso serviço. Trata-se de um método percutâneo seguro e eficaz que tem como objetivo a cura, minimiza o trauma e a morbidade do procedimento, quando comparado com o método convencional de ressecção em bloco.

Osteoma osteoide de cuello femoral: A propósito de un caso / Femoral neck osteoid osteoma: about a case

El osteoma osteoide es un tumor óseo benigno, de pequeño tamaño, sin potencial de crecimiento. Habitualmente se considera a los tumores óseos benignos y malignos como una causa poco frecuente de cojera en apirexia, siendo más frecuentes las patologías inflamatorias inespecíficas como la sinovitis transitoria de cadera, la enfermedad de Perthes y la condropatía conjugal del adolescente. Se presenta el caso clínico de un escolar de 8 años con una cojera dolorosa en apirexia de 4 meses de evolución con sospecha imagenológica de osteoma osteoide de cuello de fémur. Se decide realizar prueba terapéutica con ácido acetilsalicílico. A las 24 horas el niño se encontraba asintomático. Se indicó procedimiento quirúrgico de resección mediante punción bajo tomografía axial computada. El diagnóstico se confirmó mediante anatomía patológica. Se realizó resección completa del tumor con buena evolución. Es importante desde el punto de vista pediátrico realizar un correcto diagnóstico diferencial entre las diferentes causas de cojera dolorosa en apirexia, basándonos en la historia clínica y la imagenología.

Osteoid osteomas are small benign bone tumors which lack growth potential. All bone tumors, whether benign or malign, are considered a rare cause of apyretic limping, being non-specific inflammatory diseases more frequent, such as transient synovitis of the hip, Perthes disease and adolescent conjugal chondropathy. The study presents the clinical case of an 8 year old school boy with a 4 month evolution painful apyretic limp, being there a suspicion of femoral neck osteoid osteoma according to imaging studies. Therapeutic trial of acetylsalicylic acid was performed. Twenty four hours later the boy was asymptomatic. A tomography-guided puncture was indicated. Clinical diagnosis was pathologically confirmed. Subsequently, complete surgical resection of the tumor was performed, the evolution being favorable. From a pediatric perspective it is important to make an accurate differential diagnosis between the different possible causes of painful apyretic limp, based on clinical history and imaging studies.

Osteoid osteoma of the distal clavicle / Osteoma osteóide da clavícula distal

ABSTRACT The osteoid osteoma is a bone tumor that accounts for 10% of benign tumors. It was described in 1935 by Jaffe, as a tumor that affects the young adult population, with a predominance of males. This study aims to present a case of late diagnosis of a patient with osteoid osteoma of the distal clavicle region. Female patient, 44 years old, non-professional volleyball player, reported pain in the anterior and superior region of the shoulder girdle, specifically in the acromioclavicular joint, which worsened at night and had been treated for nine months as tendinitis of the rotator cuff and acromioclavicular joint arthritis. After confirming the diagnosis, the patient underwent open surgery with resection of the distal clavicle. At two years of follow-up, the patient presents without local pain. In the radiographic evaluation, coracoclavicular distance is preserved and there are no signs of recurrence. Tumors of the shoulder girdle are rare and are often diagnosed late. A high degree of suspicion for the diagnosis of tumors of the shoulder girdle is needed in order to avoid late diagnosis.

RESUMO O osteoma osteóide é um tumor ósseo que corresponde a 10% dos tumores benignos. Foi descrito em 1935 por Jaffe, como um tumor que acomete a população adulta jovem, com predominância no sexo masculino. O objetivo do trabalho é apresentar um caso de diagnóstico tardio de uma paciente com osteoma osteóide da região da clavícula distal e relatar seu tratamento. Paciente de 44 anos, jogadora de vôlei não profissional, com dores na região anterior e superior da cintura escapular, mais especificamente na articulação acromioclavicular, as quais pioravam a noite e que era tratada havia nove meses como uma tendinite do manguito rotador e artrite da articulação acromioclavicular. Após confirmação diagnóstica, a paciente foi submetida ao tratamento cirúrgico aberto com ressecção da clavícula distal. Atualmente a paciente encontra-se com dois anos de evolução sem dor local. Na avaliação radiográfica, a distância coracoclavicular encontra-se preservada e não há sinais de recidiva. Tumores ósseos da cintura escapular são raros e frequentemente são diagnosticados tardiamente. Deve-se ter um alto grau de suspeição para o diagnóstico de neoplasias da cintura escapular, a fim de evitar o diagnóstico tardio.

A large osteoid osteoma of the mandibular condyle causing conductive hearing loss: a case report and review of literature

Osteoid osteomas are benign skeletal neoplasms that are commonly encountered in the bones of the lower extremities, but are exceedingly rare in jaw bones with a prevalence of less than 1%. This unique clinical entity is usually seen in younger individuals, with nocturnal pain and swelling as its characteristic clinical manifestations. The size of the lesion is rarely found to be more than 2 cm. We hereby report a rare case of osteoid osteoma originating from the neck of the mandibular condyle that grew to large enough proportions to result in conductive hearing loss in addition to pain, swelling and restricted mouth opening. In addition, an effort has been made to review all the documented cases of osteoid osteomas of the jaws that have been published in the literature thus far.

Subperiosteal Osteoid Osteoma of the Knee: Case Report

Osteoid osteoma, a frequent lesions of bone, is usually intraosseous but occasionally subperiosteal. We describe the case of a 19-year-old male with knee pain caused by subperiosteal osteoid osteoma. Radiologic evaluation was performed with radiographic, computed tomography (CT), ultrasonographic (US) and magnetic resonance imaging (MRI). But the preoperative diagnosis of osteoid osteoma was delayed because of unusual imaging findings and atypical symptom. After excisional biopsy, histological examination confirmed the diagnosis of osteoid osteoma. The lesion was treated successfully with CT-guided radiofrequency ablation.

Navigated Pin-Point Approach to Osteoid Osteoma Adjacent to the Facet Joint of Spine

Osteoid osteoma (OO) is a benign osteoblastic tumor. Its curative treatment is complete removal of the nidus, where intraoperative localization of the nidus governs clinical results. However, treatment can be difficult since the lesion is often invisible over the bony surface. Accordingly, establishment of an ideal less invasive surgical strategy for spinal OO remains yet unsettled. We illustrate the efficacy of a computed tomography (CT)-based navigation system in excising OO located adjacent to the facet joint of spine. In our 2 cases, complete and pin-point removal of the nidus located close to the facet joint was successfully achieved, without excessive removal of the bone potentially leading to spinal instability and possible damage of nearby neurovascular structures. We advocate a less invasive approach to spinal OO, particularly in an environment with an available CT-based navigation system.

Nasal endoscopic surgery for osteoid osteoma of the periorbital skull base: a case report / 临床耳鼻咽喉头颈外科杂志

Osteoid osteoma was first reported in 1935 by Jaffe. It is a kind of benign bone disease with the limitation of well-defined lesions. It is rarely seen in the periorbital region. The only symptom of the patient was unilateral proptosis of right. The result of MRI examination was cystic masses in the edge of the right orbit. The tumor was complete removed by the nasal endoscopic approach during the surgery. Pathology result was reported as osteoid osteoma. There was no significant complications of diplopia, visual acuity decreased, enophthalmos, cerebrospinal fluid leakage and others.