Ortho

Osteoid Osteoma

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Osteoid Osteoma, Benign Osteoid Osteoma of Bone

  • Epidemiology
  1. Most common under age 20 years old (70% of cases)
  • Pathophysiology
  1. Benign neoplasm arising in bone (esp. long bones)
  2. Lesion center contains Osteoblasts that produce both osteoid and to a lesser extent, bone
  3. Lesion surrounded by hypervascular sclerotic bone, that limits growth
  • Symptoms
  1. Focal night pain
  • Signs
  1. Leg Length Discrepancy may occur (due to asymmetric growth)
  2. Focal findings may occur
    1. Localized swelling
    2. Muscle atrophy or contractures may form
  • Imaging
  1. XRay
    1. Bone lucency with central, core density
  2. MRI
    1. Indicated in non-diagnostic XRay
  • Management
  1. NSAIDs
  2. Lesion destruction (surgical excision or radiofrequency ablation)
    1. Indicated in severe pain or persistent course
    2. Lesions may recurr after excision
  • Course
  1. Lesions typically resolve spontaneously over months to years
  • References
  1. Gardiner (2018) Crit Dec Emerg Med 37(5): 3-14