Hand osteoid osteoma: evaluation of diagnosis and treatment

Abstract

BackgroundOO (osteoid osteoma) is a common, osteoblastic, benign bone tumor but rarely seen in the hand region. There is still some debate about the diagnosis and treatment of hand OOs. In the present study, we aimed to evaluate the epidemiology, radiologic features, surgical treatment options and functional outcomes.MethodsBetween January 2003 and December 2014, surgically treated and pathologically verified 9 hand OO cases were investigated retrospectively. The preoperative and postoperative clinical outcome scores were calculated using the M2-DASH (Manchester-Modified Disabilities of Arm Shoulder and Hand) Score.ResultsLesion locations were as follows: middle phalanx in 2/9 (22%) patients (2nd and 4th digit), proximal phalanx in 6/9 (67%) patients (one 4th, two 2nd and three 5th digits) and metacarpal (2nd) in 1/9 (11%) patient. Incidence of nidus formation was 6/9 (67%) on X-ray, 7/9 (78%) on CT imaging and 2/9 (22%) on MR imaging. The mean time to diagnosis was 13.22 ± 5.44 months. Preoperative mean M2-DASH score was 41 ± 6 and postoperative was 7.4 ± 8.6.ConclusionOsteoid osteoma is usually seen below 25 years, and rarely found over 40 years of age. There is male dominance with a male to female ratio of 3:1. Delay of diagnosis may be encountered because of many differential diagnoses. When OO is suspected, CT imaging should be taken before the MR imaging. Because of superiority in soft tissue imaging, MR imaging should be an alternative tool in complex cases.

Osteoid osteoma in the bones of the hand: a systematic literature review

“…The average age in the cohort studied was 26 years, with most patients aged between 20 and 29 years (53%). A frequent occurrence of OO in male patients could also be confirmed in our review [10,34]. Together, these epidemiologic data are consistent with the literature, although this review shows that relatively more women may be affected and the mean age is slightly higher (female 38.5%, male 71.1%) [30].…”

“…Osteoid osteoma (OO), first reported by Jaffe 1935, is a benign bone tumor which is mostly present in the tibia, femur and other long bones, but may also occur at atypical locations [17,30]. Its typical characteristic in imaging such as radiography, MRI (magnetic resonance imaging) and CT is a central nidus that contains high amounts of osteoid and is surrounded by sclerotic osseous tissue [10,20]. The etiology of OO is unknown.…”

Osteoid osteoma of the wrist misdiagnosed as de Quervain’s tenosynovitis due to normal X-ray at the first visit: A case report

“…The lesion is characterized as a well-defined lytic area with a vascularized central nidus surrounded by sclerosis and cortical thickening, as observed on X-ray and CT images. MR imaging usually shows an extensive bone marrow and/or soft tissue edema [ 11 ]. CT and MRI imaging are expensive and usually not performed on the first visit.…”

Osteoid Osteoma, a Diagnostic Problem: A Series of Atypical and Mimicking Presentations and Review of the Recent Literature

“…However, in cases of OO localised to a hand, en bloc resection often requires bone grafting. Unroofing and curettage with the burr-down method seems to be effective in preventing residual tumours or relapses of OO of the hand [ 78 ].…”