Cases reported "Osteoma, Osteoid"

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1/224. Painless osteoid osteoma in a metacarpal.

    Osteoid osteoma is a benign primary tumour of bone occurring in the first two decades of life. It presents with pain and is uncommon in the hand, particularly so in the metacarpals. We report a painless osteoid osteoma affecting a metacarpal.
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2/224. Occipital pain in osteoid osteoma of the atlas. A report of two cases.

    STUDY DESIGN: Two cases of occipital pain caused by an osteoid osteoma of the atlas are presented. OBJECTIVES: To describe the management of occipital pain in two young patients. SUMMARY OF BACKGROUND DATA: Osteoid osteoma is a benign lesion mostly affecting the long bones. A spinal location is uncommon. To the authors' knowledge, there are only five other reports of an osteoid osteoma located in the atlas. methods: Occipital headache, which was relieved by salicylates, was the major symptom reported by the two adolescents. In the first patient, a lesion of C1 was seen on plain radiographs. In the second patient, the diagnosis of osteoid osteoma was suggested by scintigraphic imaging and subsequently by computed tomography. RESULTS: pain disappeared in both cases after surgical excision of the lesion. Histologic examination disclosed characteristic features of osteoid osteoma. CONCLUSIONS: Occipital pain in adolescents, which is relieved by aspirin, should raise suspicion about the possibility of an osteoid osteoma of the atlas. If standard cervical spine radiographs are negative, isotope scanning and computed tomography can help to establish the diagnosis. Complete excision eliminates the lesion and produces immediate relief for the patient.
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3/224. role of radionuclide imaging in osteoid osteoma.

    Radiophosphate bone scans readily disclosed osteoid osteomas in 20 symptomatic patients, including nine patients whose radiographic findings had been negative. In five of the nine patients adjuvant radiogallium imaging was performed, and four showed a disproportionately low uptake relative to radiophosphate. When this occurs, osteoid osteoma can be distinguished from subacute osteomyelitis, which is particularly helpful if the radiograph is equivocal. Radiophosphate bone imaging's generally accepted excellent sensitivity in disclosing obscure symptom-producing focal bone disorders makes it the screening procedure of choice, especially if osteoid osteoma is considered in the differential diagnosis. Only abnormal areas need to be radiographed to add specificity and more precise delineation.
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4/224. Unusual manifestation of an osteoid osteoma of the capitate.

    A case of osteoid osteoma of the capitate in a 29-year-old male is reported. The patient suffered from unspecific clinical findings and a 3-year history of uncharacteristic wrist pain. Conventional radiographs of the wrist revealed a circumscribed sclerosis in the proximal part of the capitate bone beside a diffuse demineralisation of the carpal bones. magnetic resonance imaging demonstrated a circumscribed, tumorous lesion with marked enhancement after IV administration of contrast agent and a highly calcified nidus, which was sharply demarcated by a small rim of granulation tissue from the surrounding spongious bone. Based on MRI findings, the diagnosis of an osteoid osteoma was established and confirmed after operation and histologic analysis.
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5/224. Osteoid osteoma of the acetabulum. Three cases treated by percutaneous resection.

    The acetabulum is a rare location for osteoid osteoma. Conventional surgery of such lesions may require either a large bone resection, an arthrotomy, or a hip dislocation. This report describes the technique and results of percutaneous lesion removal using computed tomography guidance in three osteoid osteomas of the acetabulum. Histologic confirmation was obtained in the three cases. The three patients experienced complete pain relief with a mean followup of 36 months.
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6/224. Benign osteoblastoma.

    Benign osteoblastoma is a benign bone-forming lesion, seen most commonly in the first three decades of life and having a predilection for the vertebral column and the short limb bones. It is distinguishable from osteoid osteoma on the bases of size (being more than one centimetre in diameter) and the absence of surrounding sclerosis. The two lesions, however, are probably of the same origin and behave differently because of their different situations. Treatment is by operation, either excision in whole if practicable, or thorough piecemeal excision and curettage, with bone grafting of the defect if indicated.
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7/224. Osteoid osteoma after a stress fracture of the tibia: a case report.

    A 24-year-old man presented with a stress fracture over his left tibia following an infantry training 6 years ago. x-rays of his left tibia revealed a stress fracture and bone scan showed marked tracer uptake at the fracture. He was treated conservatively but his pain persisted since then. Five years later, x-rays and histological examination confirmed the diagnosis of osteoid osteoma. The stress fracture may act as a trigger for the formation of osteoid osteoma and caused a delay in diagnosis.
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8/224. Osteoid osteoma of a cervical vertebral body.

    An osteoid osteoma in the anterior part of the body of the fourth cervical vertebra occurred in a 22-year-old female. The patient's main complaint was neck pain and occasional numbness of the extremities. The pain was relieved by analgesics. Plain radiography and a 99Tcm MDP bone scan showed a non-specific abnormality. CT suggested the pathological diagnosis with reasonable certainty. The unusual location of the lesion and the role of various diagnostic modalities are discussed and the literature reviewed.
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9/224. Osteoid osteoma of the spine treated with percutaneous computed tomography-guided thermocoagulation.

    STUDY DESIGN: Two cases are reported in which an osteoid osteoma of the lumbar spine was treated with CT-guided thermocoagulation. OBJECTIVES: To review an alternative and minimally invasive treatment for spinal osteoid osteomas. SUMMARY OF BACKGROUND DATA: Surgical resection of a spinal osteoid osteoma can, depending on the location, be a formidable undertaking. Bone scintigraphy can be helpful in intraoperative identification. More recently, resection through a computed tomography-guided drill hole was found to minimize exposure. Using a thermocoagulation probe, as has been used in osteoid osteoma of the extremities, may be technically easier and cause less morbidity. METHOD: With the patient under general anesthesia, a bone biopsy cannula was introduced into the center of the osteoid osteoma. Material was subjected to histologic examination. A thermocoagulation probe was then inserted and heated to 90 C for 4 minutes. The two patients were kept overnight for observation. RESULTS: Both patients had complete pain relief and no evidence of recurrence after 2 years' follow-up. There were no complications. scoliosis resolved in one patient and persisted in the other. CONCLUSION: Percutaneous computed tomography-guided thermocoagulation is a minimally invasive and technically straightforward method to achieve ablation of a spinal osteoid osteoma. No complications were encountered in these two patients. Future research should focus on the safety of thermocoagulation, especially cephalad to the level of the conus medullaris.
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10/224. Painless osteoid osteoma of the finger in a child. Case report.

    The authors report the case of an 8-year-old child presenting with painless swelling of the middle phalanx of the ring finger. radiology demonstrated simple hypertrophy of cortical bone with a clear zone. Bone biopsy showed the typical features of osteoid osteoma. Osteoid osteoma is rarely painless and generally corresponds to a superficial tumour (hand, foot, skull and thorax).
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