Osteoid osteoma

Case contributed by Andrew Kirby
Diagnosis almost certain

Presentation

Limp for 6 weeks, worse at night. Relieved by aspirin.

x-ray

Subtle increased sclerosis of the proximal tibia. No nidus is visible.

mri

Well circumscribed T2 bright lesion at the posterior aspect of the proximal tibial metaphysis. Marked adjacent soft tissue inflammation. At this point the differential is between osteoid osteoma and infection.

ct

CT demonstrates the classic findings of a poorly defined area of sclerosis with a central lucent nidus. This was treated with CT guided RF ablation to good effect.

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