Osteoid osteoma

Case
A 23-year-old female player presented with a six-month history of posterior thigh pain. While she related the onset of pain to playing football, she did not give a clear history of trauma. The pain reliably woke her from sleep (at about 4am) each night and was almost completely eliminated when she took oral ibuprofen before bed. A hanging leg test (fulcrum test) reproduced her thigh pain.

Findings
A lateral x-ray shows smooth cortical thickening of posterior femur. There is no aggressive periosteal reaction, evidence of fracture or soft tissue abnormality. On MRI there is a fusiform thickening of the posterior femoral cortex with a small intracortical focus of T2 hyperintensity. There was enhancement of the intracortical area after contrast. Subsequent CT imaging further demonstrates the cortical thickening and demonstrates an ovoid-shaped, lucent ‘nidus’. Appearances are most consistent with an osteoid osteoma.

Discussion
This young woman was diagnosed with an osteoid osteoma based on her history and radiology findings. She has been referred for radiofrequency ablation of the lesion. This procedure is less invasive than surgical resection and is successful in up to 96% of cases.

Osteoid osteomas are a relatively common benign bone tumour. They are most frequently found in long bones, such as the femur and tibia, but can occur at any site. They generally present in younger patients (being most common before the third decade) and are approximately three times more common in males. The most common presenting symptom is pain. This is classically worse at night and is improved with oral NSAID.

Cortical thickening surrounding a small central core of lower density (the nidus) are the classical radiological finding. X-rays may be normal; however, the cortical thickening is generally well visualised with this imaging modality. The central ‘nidus’ is sometimes visible on x-rays as a well-circumscribed lucent region, occasionally with a central sclerotic dot. CT imaging is generally considered to be the imaging modality of choice. The nidus is generally best appreciated on this imaging modality appearing as a focally lucent area within surrounding sclerotic reactive bone. A biopsy may also be needed to confirm the diagnosis in some cases.

Important notice
FIFA does not bear any responsibility for the accuracy and completeness of any information provided in the “Radiology Review” features and cannot be held liable with regard to the information provided or any acts or omissions occurring on the basis of this information.

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Rodrigo PeixotoBangouraEhabJuma al hinaiASHOK KUMAR CHOUDHARY Recent comment authors
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Amir
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Amir

Good job

Kamereddine
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Kamereddine

Good goooooood

Ahmed abdin seyam hassan
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Ahmed abdin seyam hassan

Welldone

Dr. Khaled M Khalifa
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Dr. Khaled M Khalifa

Good job 👍🏻, history is very suggestive for diagnosis

special one
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special one

good job

Ivan andres
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Ivan andres

Caso interesante, no sólo con la historia del paciente es suficiente se deben realizar diferentes pruebas para tener un mejor diagnóstico y rehabilitación

C. Aktham Waleed Alkasem
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C. Aktham Waleed Alkasem

Goooood

Md. Masum Zikrul
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Md. Masum Zikrul

Very helpful

Ahmed
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Ahmed

Coach Football

Felipe silva de oliveira
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Felipe silva de oliveira

boa revisão parabéns

طارق عادل محمد
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طارق عادل محمد

موضوع مفيد جدا واحترم رأي الاخرين

Gazi
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تم

Abo Bakr
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Good job

Nidal mohamed abdallah ali
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Good joi

Nidal mohamed abdallah ali
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Good job

DR. ASHOK
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DR. ASHOK

Yes

JUMA MOHAMMED ABDAN AL HINAI
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JUMA MOHAMMED ABDAN AL HINAI

useful information, thanks

Ehab
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Ehab

شكرا

Ehab
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Ehab

شكرا لكم

Bangoura
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Bangoura

L OSTEOME OSTEOIDE EST UNE TUMEUR OSSEUSE BENIGNE D UNE TAILLE INFERIEURE A 2CM DE DIAMETRE FORTEMENT VASCULARISEE
LE TRAITEMENT EST CHIRURGICALE

Rodrigo Peixoto
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Rodrigo Peixoto

not so common case, but very interesting to add in the diagnostic possibilities