Hurdles for Starting Ministernotomy Aortic Valve Replacement Program

Osteoid osteoma of the ribs-Is image intensifier or bone scintigraphy a mandatory diagnostic tool-A case report with Review of literature

“…OOs may affect any bone, but more than half of the tumours occur in the long bones of the lower extremities. The frequency of OOs affecting the ribs is extremely low (1-1.4%), with only 14 reported cases with surgical intervention to date [3][4][5][6][7][8][9][10][11][12][13][14][15][16]. Our case had presented itself at an age which is beyond the normal age group of incidence [3].…”

“…Imaging typically reveals a small radiolucent lesion with a thick sclerotic margin of reactive bone. Due its accuracy in detecting the nidus, CT is the preferred imaging technique used for the assessment of osteoid osteomas [3,7,15,18]. When the osteoid osteoma occurs in the posterior portion of the rib near the spine, it may lead to scoliosis [19] Both conservative and operative techniques have been reported for the treatment of OO.…”

“…The common principle for operative treatment of OO is thorough resection of the nidus, but incomplete resection could lead to local recurrence [20] . Although the ribs are easily accessed, the reported lengths of en bloc resection of the nidus ranged from 5 to 9.5 cm, which is significantly wider than the size of the nidus, that have led to varying reports of functional impairments [3,[5][6][7]. Klonecke et al [20] reported that intraoperative scanning has evolved because of the excessively wide excision necessary in the past that had to be planned to help guarantee complete removal of the lesion.…”

“…As per the available literature of the 15 cases of rib osteomas reported so far, we have come to the following consensus [3][4][5][6][7][8][9][10][11][12][13][14][15][16] as in Table 1.…”

“…No localizing diagnostic modality was used by 3 authors [8,15]. Pre-operative CT imaging was used by all authors [3][4][5][6][7][8][9][10][11][12][13][14][15][16]. No data was available in case of 4 reports [5,9,11,13].…”