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.

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.

Osteoid osteoma of the patella presenting as chronic anterior knee pain case report and review of the literature

Osteoid osteoma is a benign bone forming tumor with a characteristic radiographic appearance. Femur and tibia is the frequent site of involvement. Osteoid osteoma in the patella is a rare condition of which only a few cases have been reported in the literature. Non-specific knee pain, difficulty to distinguish nidus, and lack of typical sclerotic bone formation in plain radiographs cause a delay in diagnosis. We report a 15 years old girl with anterior left knee pain since 1.5 year. Imaging findings and biopsy of the lesion confirmed osteoid osteoma. The pain was relieved after surgical resection of the tumor and patient was symptom free with no evidence of recurrence at 12 months after surgery

Abnormal presentation of osteoid osteoma

We describe a rare location of Osteoid Osteoma in the diaphysis of the ulna in a 12 year old girl. The lesion was missed initially due to difficult identification of the nidus by radiography and CT Scan, The patient was treated with wide surgical excision in order to avoid recurrence