Osteoid osteoma of the proximal humerus: A misleading case

Mitsui, Yasuhiro; Gotoh, Masafumi; Yoshida, Takefumi; Hirai, Yoshimasa; Shinozaki, Toshiro; Nakama, Kenjirou; Higuchi, Fujio; Nagata, Kensei

doi:10.1016/j.jse.2007.02.119

Cited by 10 publications

(16 citation statements)

References 7 publications

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“…1,3,7 Atypical locations include the skull, ribs, ischium, mandible, patella, and proximal humerus. 1,3,4 Osteoid osteomas are classified as cortical (most prevalent), cancellous, and subperiosteal, with the latter two typically arising in an intraarticular or juxtaarticular location. 3 Extraarticular cortical tumors demonstrate a radiologic appearance of a representative centralized radiolucent "nidus," rarely greater than 1.5 cm, surrounded by a sclerotic rim in the shaft of a long bone.…”

Section: Discussionmentioning

confidence: 99%

“…1,3-5,10 Unusual locations and equivocal early radiological findings are common and can result in diagnostic difficulties, particularly those that are intraarticular. 3,4,7,13 Patients typically have mild initial pain that is progressive over time and nocturnal pain that is relieved with anti-inflammatory medication. [3][4][5]7,13,14 The radiolucent nidus contains nerve fibers, vascular elements, and prostaglandins that may be responsible for chronic reactive change in the surrounding bone resulting in periosteal sclerosis and synovitis.…”

Section: Discussionmentioning

confidence: 99%

“…3,4,7,13 Patients typically have mild initial pain that is progressive over time and nocturnal pain that is relieved with anti-inflammatory medication. [3][4][5]7,13,14 The radiolucent nidus contains nerve fibers, vascular elements, and prostaglandins that may be responsible for chronic reactive change in the surrounding bone resulting in periosteal sclerosis and synovitis. 3,15 The prostaglandin concentration is thought to be responsible for the constant and severe pain because the vasodilatory effect increases intracortical pressure within the nidus.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5][6] There is a predilection of these tumors to arise in the femur and tibia, with a remaining equal distribution reported in the spine, hand, and foot. 3,4 Atypical locations can occur, but are rare, as in this case, in the proximal metadiaphyseal region of the humerus [1][2][3][4]7 ; and osteoid osteoma is rarely reported in the medical literature. [1][2][3][4] As well, there is a paucity of osteoid osteoma cases in the chiropractic literature.…”

Section: Introductionmentioning

confidence: 99%

“…3,4 Atypical locations can occur, but are rare, as in this case, in the proximal metadiaphyseal region of the humerus [1][2][3][4]7 ; and osteoid osteoma is rarely reported in the medical literature. [1][2][3][4] As well, there is a paucity of osteoid osteoma cases in the chiropractic literature. There are only 2 cases of osteoid osteoma reported.…”

Section: Introductionmentioning

confidence: 99%

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Occult osteoid osteoma presenting as shoulder pain: a case report

Zoboski¹

2012

Journal of Chiropractic Medicine

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Objective: The purpose of this case study is to describe the clinical course and treatment of a patient with recalcitrant shoulder pain and osteoid osteoma. Clinical Features: A 28-year-old man had a 2-year history of progressively worsening shoulder and midscapular pain. Intervention and Outcome: Before chiropractic consultation, he had been evaluated and treated by his family physician, an orthopedic surgeon, a neurologist, and a pain management specialist. The patient underwent arthroscopy with examination under anesthesia and debridement of a posterior labral tear and cervical spine epidural injections, but neither procedure relieved his symptoms. After seeking chiropractic care, presenting symptoms were reproducible during direct clinical examination; and an initial working diagnosis of secondary right glenohumeral impingement syndrome with coexisting scapulothoracic dyskinesis was made. After 2 weeks of chiropractic rehabilitation, therapy was stopped because of no change in symptoms. The patient was referred for orthopedic consultation. Another series of plain films were ordered, and follow-up magnetic resonance imaging revealed an osseous mass at the medial aspect of the proximal metadiaphyseal region of the right humerus, with a diagnosis of osteoid osteoma. The patient underwent radiofrequency thermoablation of the tumor nidus, which was unsuccessful and resulted in open surgical resection. Resolution of symptoms with minimal pain was reported 3 weeks after the surgery. Four years later, the patient's shoulder remains asymptomatic. Conclusion: This case demonstrates that osteoid osteoma may present with clinical features that mimic common functional musculoskeletal conditions of the shoulder. Information from the patient history and diagnostic imaging are important for diagnosis and appropriate management.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Occult osteoid osteoma presenting as shoulder pain: a case report

Zoboski¹

2012

Journal of Chiropractic Medicine

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Arthroscopic removal of an osteoid osteoma of the acetabulum

Barnhard

Raven

2011

Knee Surg Sports Traumatol Arthrosc

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In this case report, we describe the arthroscopic removal of an osteoid osteoma from the acetabulum in a young adolescent. After identifying the osteoid osteoma close to the cartilage with MRI and CT investigations, we decided that in this case, arthroscopic removal was the best treatment. In the case of an osteoid osteoma in the acetabulum close to the cartilage, arthroscopic removal should be considered as one can treat the associated osteochondritic lesion during this procedure.Level of evidence IV.

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