Osteoid osteoma

Case contributed by Dr Mahmoud Yacout Alabd

Presentation

Chronic left hip pain with limited flexion and rotation, with suspicious inflammatory hip joint pathology.

Patient Data

Age: 12 y
Gender: Male
Modality: X-ray

Sclerotic periosteal reaction and thickening at the medial aspect of the femoral neck with a defined oval lucency. 

Modality: CT

Typical appearance of osteoid osteoma with thickened cortex and a rounded cortical lucency showing a faint central nidus. 

Modality: MRI

The MRI demonstrates the lesion as T2 bright signal well defined area and low signal sclerotic periosteal reaction with surrounding bone marrow and soft tissue edema as well as hip joint effusion, explaining the child's symptoms and movement limitation. There is also post contrast enhancement of the lesion and surrounding reaction as expected. 

Case Discussion

Osteoid osteoma typically affects young individuals. Typical radiological appearance is a small well defined lucency with a small central nidus and surrounding periosteal reaction with or without soft tissue reaction. The patients present with pain, more in night that is typically relieved by salicylates. When occurring close to a joint the clinical presentation can mimic that of inflammatory arthritis or synovitis as in this case.

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Case Information

rID: 44226
Case created: 12th Apr 2016
Last edited: 9th Jun 2016
Inclusion in quiz mode: Included

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