Osteoid osteoma

Case contributed by Abdulmajid Bawazeer

Presentation

Medically free patient came complaining of six months of thigh pain being more at night with no history of trauma.

Patient Data

Age: 15 years
Gender: Female
x-ray

The right femur shows cortical thickening in mid diaphysis, no bone destruction or soft tissue component.

ct

The lateral aspect of right femur shows cortical thickening in mid diaphysis with small nidus measuring about 6-7 mm, no bone destruction or soft tissue component.

mri

The previously seen cortical thickening shows the nidus clearly with focal intramedullary bone marrow edema and periosteal reaction, with no other bony or muscular abnormality.

ct

Radiofrequency thermal ablation under CT guidance was the management decision with increasing frequency to therapeutic limits.

Case Discussion

Always history and clinical exam play a significant role to narrow the differential diagnosis.
The radiograph, CT scan, MRI and skeletal scintigraphy (not shown due to unavailable soft copy) are pointing osteoid osteoma.
Radiofrequency thermal ablation was the management choice.
NB: ​Skeletal scintigraphy shows focal-high uptake at the same site.

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