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Osteoid osteoma (OO) is a small and painful benign osteoblastic tumour located preferentially in the shaft of long bones near the metaphyseal junctions, with a predilection for the lower limbs. Juxta- and intra-articular OOs are rare and even though hip, elbow, and talus are the most commonly reported locations, they may be found in any joint accou...
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RESUMEN 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: Presen...
RESUMEN 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: Presen...
Background
OO (osteoid osteoma) is a common, osteoblastic, benign bone tumor but rarely seen in the hand region. There is still some debate about the diagnosis and treatment of hand OOs. In the present study, we aimed to evaluate the epidemiology, radiologic features, surgical treatment options and functional outcomes.
Methods
Between January 2003...
Citations
... Pain and limited movement are common complaints and many of these cases with non-specific symptoms witness a delay in the definitive diagnosis. Many are misdiagnosed and treated for synovial disorder, enthesopathy, or sequela of old trauma [6]. Juxta-and intra-articular osteoid osteoma are rare lesions and Table 1: A list of recently described selected individual cases with osteoid osteoma in the intra-articular elbow region (coronoid/olecranon fossa) in the past 5 years (year 2018 onward) may arise from any joint but common reported locations are hip, elbow, and talus. ...
... This can be an optional management method that is minimal invasive and works well in difficult locations [8]. Arthroscopybased interventions such as excision, curettage, debridement, and synovectomy have also been frequently reported in recent times [5,6,7,9]. In a recent systematic review, successful outcomes in the range of 93.8% along with zero post-operative complication and recurrence rate have been reported [10]. ...
Introduction:The elbow pain and restricted movement is a nagging problem and elbow arthropathies need to be excluded. On rare instances, uncommon etiology like a benign lesion is the culprit and the diagnosis would require judicious clinicoradiological correlation. Osteoid osteoma in the intra- or juxta-articular region is reported in the literature as rare, sporadic report.
Case Report: A 23-year-old, Indian male patient presented with a provisional diagnosis of early elbow arthropathy on account of unexplained pain and restricted elbow movement without a history of trauma. He was subjected to appropriate investigations revealing synovial hypertrophy, effusion, and bone edema suggestive of early arthropathy. Additional imaging led to an uncommon definitive diagnosis. An intra-articular
osteoid osteoma was found over the medial aspect of the coronoid fossa with a thin rim of cortical rim projecting anteriorly. The lesion was
diagnosed and delineated on computerized tomography and an open excision of the lesion and synovectomy was done for histopathological
evaluation. Histology confirmed the presence of an osteoid osteoma at an uncommon location.
Conclusion:The careful appreciation of radiological images is critical to not miss significant etiology that may mimic non-specific elbow pain.
High index of suspicion coupled with appropriate diagnostic imaging results in early diagnosis and appropriate management. Osteoid osteoma should be a differential diagnosis in cases with pain and restricted elbow movement and excision of which results in recovery of painless range of motion.
Keywords:Elbow, osteoid osteoma, arthritis, coronoid fossa, elbow pain.
... At the final follow-up appointment, the mean postoperative was MEPS was 95 ± 7.1 compared to preoperative MEPS of 52 ± 16.8. A review of the literature regarding arthroscopic elbow OO ablation produced 13 studies from 2006 to 2021 (Table 2) [14,23,[25][26][27][36][37][38][39][40][41][42][43]. The studies involved a total of 23 patients, predominantly male (5 to 1). ...
... Moreover, in 2020 Ge et al. [20] in another systematic review, examined arthroscopic management of intra-and juxta-articular osteoid osteoma of the upper extremities and concluded that arthroscopic ablation of the shoulder and wrist OOs was successful in 100% of cases with no complications or recurrences. We expanded on their research regarding ablation of intraarticular elbow OO complementing it with three additional studies adding up to a total success rate of 86.4%, no recurrences and one minor complication (4.5%) after arthroscopic ablation of intra-and juxta-articular elbow OOs [14,23,[25][26][27][36][37][38][39][40][41][42][43]. Treatment failures (15.6%) included three patients requiring additional surgical intervention, 2 due to residual pain and one case of residual elbow contracture [23,37]. ...
Background
Today, intra-articular and juxta-articular osteoid osteomas are treated with arthroscopy and radiofrequency thermal ablation. However, for the case of an elbow joint, arguments are made for the use of a minimally invasive technique to be the optimal choice. This study aims to analyse our experiences of arthroscopically treated elbow osteoid osteomas and to compare it with the published results of both techniques.
Methods
The retrospective study analyses the patients who underwent elbow arthroscopy ablation of an elbow osteoid osteoma at a single institution from January 2014 until March 2020. Clinical and diagnostic features, success and treatment failure rates, complications and tumour recurrence rates were all compared to 13 studies of intra-articular elbow osteoid osteoma arthroscopic ablation and 15 studies involving radiofrequency thermal ablation of intra-articular osteoid osteoma within different joints.
Results
Four males and two females, with a mean age of 19.3 years, were encompassed. All the patients had immediate postoperative pain relief and improved range of motion. No tumour recurrences were observed during a median of 21.7 months. The literature review yielded 86.4% success rate, 68.2% successful biopsies, one minor complication and no recurrences following the arthroscopic ablation of an elbow osteoid osteoma; while radiofrequency thermal ablation of an intra-articular elbow osteoid osteoma yielded 96.3% success rate, 33.3% successful biopsies, no complications and 3.7% recurrence rate.
Conclusions
Our results are consistent with the published literature proving that arthroscopic ablation is an efficient method with low treatment failure rates and no recurrences in treating intra- and juxta-articular elbow osteoid osteomas. Advantages of arthroscopic ablation stem from the ability to visualise and safely deal with the lesion and the joint’s reactive changes resulting in high biopsy rates, no recurrences and better postoperative elbow’s range of motion. Still, the technique selection should be personalised considering the medical expertise of every institution.
... Among the possible causes, an osteoid osteoma seems the most likely considering the very regular margin of this depression. Juxta-and intra-articular osteoid osteomas are rare, but can occur in the olecranon fossa, the nidus located subchondrally creating a crater-like imprint at the bottom of the fossa [42]. A less convincing cause may be a posteromedial olecranon impingement, which is a common injury encountered in the throwing elbow, and is commonly associated with osteoarthritic changes including the possible presence of loose bodies and chronic stress fracture at the olecranon process [43,44]. ...
This article reports on a complete left human humerus from the Cussac Cave (Dordogne, France), dating to the Gravettian, or Mid-Upper Palaeolithic. This humerus is characterised by a very marked retroversion, significant intracortical porosity, an unusual morphology and orientation of the medial epicondyle, and a marked depression at the bottom of the olecranon fossa. These morphological features could be related to mechanical stimuli, but this is just an assumption given the absence of control data for many factors (e.g. age-at-death, sex, body mass, degree of asymmetry). Nevertheless, the description of this new discovery contributes significantly to our understanding of the range of variation of known Late Pleistocene skeletal morphology.
... Indeed, extensive resection or recurrence, because of the incomplete resection can lead to the difficulty of obtaining satisfactory tissue specimens for pathological diagnosis (5). Accordingly, bone defect would last for a long time after wide excision and fixed protection is necessary, increasing the risk of pathological fracture (6). However, percutaneous minimally invasive laser ablation guided by CT may improve the positioning accuracy, with the advantages of light damage, fast recovery, and complete treatment (7). ...
The effects between minimally invasive percutaneous laser ablation and open surgery in the treatment of children with osteoid osteoma were compared in the present study. A total of 72 cases of children with osteoid osteoma were divided into control and observational groups, containing 36 cases in each group. The control group underwent conventional open surgery while the observational group underwent minimally invasive CT guided percutaneous laser ablation. Effects of both operations were compared. The operation duration, blood loss and plaster fixation duration of the observational group were significantly less than those of the control group. The postoperative pain score (VAS) at 1 day and 7 days were significantly lower than that of the control group, the differences were statistically significant (P<0.05). The lesion resection rate, effective rate of bone hyperplasia, effective rate of swelling and effusion and total effective rate of the observational group were significantly higher than those of the control group, the differences were statistically significant (P<0.05). Incidence of adverse reactions of observational group was significantly lower (P<0.05) than that of the control group. However, the difference was not significant when comparing 1-year recurrence rate for the two groups. The minimally invasive percutaneous laser ablation has better surgery effects compared with open surgery in the treatment of children with osteoid osteoma.
Background
Intra- and juxta-articular osteoid osteoma (OO) is rare and can result in irreversible joint damage. Recently, arthroscopic surgery is being used more and more to avoid complications associated with other treatment modalities.Methods
On October 13, 2019, we conducted a systematic review of the literature available in PubMed and EMBASE regarding the arthroscopic management of OO involving the joints of the upper extremity. Predetermined inclusion criteria were used to include any relevant article published on and before that date for further analysis. Treatment success rate and tumor recurrence rate were considered the primary outcomes in our analysis.ResultsOut of 113 studies, 19 met our inclusion criteria. Of the 32 reported cases in these 19 articles, ten involved the shoulder joint, 19 involved the elbow joint and three involved the wrist joint. Overall treatment success rate was 93.8%. Tumor recurrence rate was 0.0%. No postoperative complications (0.0%) were reported among cases involving the shoulder joint. Two out of 24 (8.3%) patients with elbow OO failed arthroscopic treatment due to incomplete excision, and two (4%) experienced minor complications. Among the three cases of wrist OO, two (66.7%) patients had residual postoperative pain and decreased hand grip strength.Conclusion
Arthroscopic management of OO of the upper extremity joints is highly successful and results in no tumor recurrence; however, there is a risk of incomplete resection in areas more difficult to access by arthroscopy.
Scopo. Descrivere gli aspetti TCMD polimorfi delle infezioni ossee, inquadrandoli, in correlazione con i rilievi cli- nico-laboratoristici e microbiologici, nelle classi diagnostiche dell’O.D.S. (Osteomyelitis Diagnosis Score, 2011). Materiali e metodi. Nel periodo gennaio 2014-dicembre 2015, 34 pazienti adulti, 14 maschi, 20 femmine (età 24- 79 anni), con sospetta infezione ossea, sono stati sottoposti a TCMD 64 slice di segmenti scheletrici. Iniezione di mdc e.v. è stata effettuata in 25 pazienti, biopsia TC guidata in 5. I reperti TCMD sono stati confrontati con i rilievi anamnestici, clinici, laboratoristici, microbiologici ed istopatologici, per consentire l’inserimento dei pazienti in
una delle classi diagnostiche (A,B,C) del’O.D.S.
Risultati. Alla TCMD sono stati osservati: demineralizzazione ossea in 18 casi (52.9%), osteolisi in 16 casi (47.0%), sclerosi cortico-spongiosa in 13 (38.2%), reazione periostale in 10 (29.4%), fistole in 7 (20.5%), sequestri in 4 (11.7%). 23 pazienti (67.6%) sono stati inseriti nella classe A, 9 (26.4%) nella B, 3 (8.8%) nella C. Conclusioni. La TCMD permette la migliore valutazione delle alterazioni morfostrutturali ossee e dell’estensione prechirurgica nelle infezioni ossee, consentendo di guidare biopsie ossee. La correlazione con gli elementi clini- co-laboratoristici, microbiologici ed istopatologici permette l’inquadramento secondo l’O.D.S.
Scopo. Valutare le potenzialità della scansione DEXA del corpo intero sia nello studio della densità minerale os- sea, a confronto con le scansioni segmentali del femore prossimale e del tratto lombare, in un gruppo di pazienti HIV+ in trattamento antiretrovirale, sia nello studio della composizione corporea nello stesso gruppo di pazienti a confronto con un gruppo di controllo di pazienti non HIV+.
Materiali e metodi. Nel periodo gennaio 2012 - dicembre 2016, 751 pazienti (601 maschi, 150 femmine, età: 24- 48 anni) HIV+, in trattamento antiretrovirale sono stati sottoposti a densitometria femorale e lombare con DXA e a densitometria dei tessuti corporei con DXA. Alle stesse indagini è stato sottoposto un gruppo di controllo di 340 pazienti non HIV+. Il parametro considerato, nella refertazione, per la diagnosi di osteoporosi, è stato il T-score rispetto al picco di massa ossea. I parametri valutati nelle densitometrie total body sono stati: T score, BMD, BMC per lo studio della densità ossea; BMI, A/G, Massa totale, Massa adiposa, Massa magra per lo studio della com- posizione corporea.
Risultati. I nostri dati preliminari, che necessitano di ulteriori validazioni e conferme, orientano per una buona correlazione dei valori di T score, ottenuti dalle scansioni del corpo intero rispetto a quelli forniti dalle scansioni segmentali a livello del femore prossimale e del tratto lombare, per la diagnosi di osteoporosi. Nei pazienti HIV in trattamento antiretrovirale, le informazioni supplementari fornite riguardo alla composizione corporea consentono misurazioni antropometriche oggettive per la diagnosi di lipodistrofia e sarcopenia.
Conclusioni. La scansione del corpo intero valuta contemporaneamente l’osteoporosi e tutte le componenti corpo- ree in pazienti HIV+ in trattamento antiretrovirale.
Scopo. Le terapie mini-invasive percutanee delle neoplasie epatiche maligne, che hanno assunto dignità di terapie alternative alla resezione chirurgica, possono essere gravate da complicanze più o meno gravi. Scopo del nostro studio è presentare aspetti TCMS di complicanze frequenti ed infrequenti delle terapie miniinvasive percutanee delle neoplasie epatiche maligne.
Materiali e metodi. È stato eseguito uno studio retrospettivo monocentrico biennale sulle complicanze rilevate alla TCMS addominale, in pazienti sottoposti a terapie mininvasive percutanee per neoplasie maligne epatiche. Nel periodo gennaio 2014-dicembre 2015, 30 pazienti, 18 maschi, 12 femmine, di età compresa tra 27 e 75 anni, sono stati trattati con terapie miniinvasive percutanee. Di questi 8 (26,6%), con sospetto clinico di complicanze, sono stati sottoposti a TCMS addominale, prima e dopo iniezione di mdc ev, mediante valutazione plurifasica, con l’apparecchiatura TCMS 64 slice, in dotazione all’UOC Radiodiagnostica dell’Ospedale Cotugno di Napoli. Risultati. Alla TCMS sono state rilevate le seguenti complicanze: 3 emoperitonei (37,5%), 2 emotoraci (25%), 2 bilomi (25%) , 2 emobilie (25%), 1 ascesso epatico (12,5%), 1 pneumotorace (12,5%). Un caso di grave emo- peritoneo è stato sottoposto ad intervento chirurgico in urgenza. In 2 casi (12,5%), la TCMS ha dimostrato colo- nizzazione peritoneale di neoplasia epatica primitiva, in 1 con presenza di localizzazioni secondarie ossee all’ala iliaca destra.
Conclusioni. La TCMS rappresenta il gold standard nello studio delle complicanze frequenti ed infrequenti, più o meno gravi delle terapie miniinvasive percutanee delle neoplasie epatiche maligne e nel loro management.
Scopo. Presentare aspetti TCMS della patologia muscolare ascessuale da piogeni attraverso l’analisi retrospettiva degli ascessi muscolari, da noi diagnosticati alla TCMS degli ultimi cinque anni.
Materiali e metodi. Nel periodo gennaio 2010-dicembre 2015, 40 pazienti (23 maschi, 17 femmine, età: 32-75 anni), 8 HIV+, 3 con AIDS, con ascessi muscolari da piogeni, sono stati sottoposti a TCMS toraco-addominale, del collo o di segmenti degli arti, in relazione alla sede interessata dal processo, con apparecchiatura 64 slice, senza e con mdc ev.
Risultati. Gli ascessi muscolari da piogeni diagnosticati conseguivano a propagazione per contiguità da spondi- lodisciti in 11/40 (27.5%), infezioni protesiche in 9/40 (22.5%), infezioni post-stabilizzazione vertebrale in 8/40 (20%), empiemi pleurici in 3/40 (7.5%), adenopatie colliquate in 3/40 (7.5%). Propagazione ematogena da sepsi generalizzata ne era alla base in 6/40 (15%). Gli ascessi erano localizzati ai muscoli psoas nel 27.5%, ai muscoli paravertebrali nel 27.5%, ai muscoli della radice della coscia nel 22.5%, ai muscoli della parete toracica nell’8%, ai muscoli della parete addominale nel 7.5%, ai muscoli del collo nel 7%. Alla TCMS si presentavano come rac- colte polimorfe di ipodensità disomogenea con ring di enhancement post-contrastografico, multiple in 34/40 casi, uniche in 6/40.
Conclusioni. Gli ascessi muscolari conseguono a diversi elevata accuratezza diagnostica nella loro diagnosi.
meccanismi patogenetici. La TCMS dopo mdc ev ha
