Osteoid osteoma - patella

Case contributed by Jeremy Jones
Diagnosis certain

Presentation

Anterior knee pain. No trauma.

Patient Data

Age: 15 years
Gender: Female
x-ray

Normal appearances. No osteochondritis. No bone lesion.

mri

5 mm T1 dark lesion in the patella. Surrounding bone edema and edema in Hoffa's fat pad. Normal cartilage. Otherwise normal examination.

ct

The patellar lesion demonstrated on the MRI is an ovoid lucent lesion with a focal hyperdense nidus and adjacent sclerosis. Appearances are of an osteoid osteoma.

ct

Medial approach to the osteoid osteoma. Successful RFA treatment.

Case Discussion

Pain was worse immediately after treatment, but within a week, pain had subsided and 3 months after treatment, she was pain free and had returned to normal activity levels.

RFA treatment for osteoid osteoma is an excellent treatment if the lesion can be accessed. Some patients report severe pain immediately after treatment and this does not preempt a poor prognosis.

While the imaging findings are diagnostic, pathological specimen was also confirmed as showing osteoid osteoma.

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