Periarticular Osteoid Osteoma of the Ankle: A Report of Nine Arthroscopically Treated Patients

Dimnjaković, Damjan; Bojanić, Ivan; Smoljanović, Tomislav; Mahnik, Alan

doi:10.1053/j.jfas.2014.09.051

Cited by 19 publications

(24 citation statements)

References 29 publications

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“…4a and b). In minimal invasive techniques like RF ablation (RFA), the nidus of the OO is usually heated to 90 °C for 4–9 min to achieve thermal coagulation necrosis which makes it impossible to perform histological examination [21–23]. Furthermore, the area of osteonecrosis might not be easy to control as RFA has been associated with occurring damage of the articular cartilage in the acetabulum [24].…”

Section: Discussionmentioning

confidence: 99%

Intra-articular osteoid osteoma as a differential diagnosis of diffuse mono-articular joint pain

Rolvien

Zustin

Mussawy

et al. 2016

BMC Musculoskelet Disord

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BackgroundThe aim of this retrospective study was to investigate the frequency of intra-articular osteoid osteoma (iaOO) in a large study cohort and to demonstrate its clinical relevance as an important differential diagnosis of non-specific mono-articular joint pain.MethodsWe searched the registry for bone tumours of the University Medical Centre Hamburg-Eppendorf for osteoid osteomas in the last 42 years. Herein, we present three selected iaOO which were detected in the three major weight-bearing joints. Computed tomography (CT) or magnetic resonance imaging (MRI) scans were performed for initial diagnosis.ResultsOut of a total of 367 osteoid osteomas, 19 (5.2 %) tumours were localized intra-articularly. In all three presented tumours, a history of severe mono-articular pain was reported; however, the mean time to correct diagnosis was delayed to 20.7 months. Clearly, the nidus seen in CT and MRI images in combination with inconsistent salicylate-responsive nocturnal pain led to the diagnosis of iaOO.ConclusionsRarely, osteoid osteoma can occur in an intra-articular location. In cases of diffuse mono-articular pain, iaOO should be considered both in large and smaller joints to avoid delays in diagnosis and therapy of this benign bone tumour.Electronic supplementary materialThe online version of this article (doi:10.1186/s12891-016-1313-3) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Intra-articular osteoid osteoma as a differential diagnosis of diffuse mono-articular joint pain

Rolvien

Zustin

Mussawy

et al. 2016

BMC Musculoskelet Disord

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“…When patients present for treatment after trauma, OO of the talus is rarely considered in the setting of long-term ankle joint pain. Without a detailed history and physical examination, it is easy to miss OO or misdiagnose it as arthrosynovitis [17–19], ankle impingement [20–22], tubercular arthritis, or osteomyelitis [23]. This may lead to incorrect treatment at an early stage.…”

Section: Discussionmentioning

confidence: 99%

A misdiagnosed case of osteoid osteoma of the talus: a case report and literature review

He¹,

Lü

et al. 2017

BMC Musculoskelet Disord

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BackgroundOsteoid osteoma (OO) is a common benign bone tumour that is rarely found in the talus. Its nidus is difficult to detect on early imaging. The atypical symptoms of OO and the presence of concurrent trauma or sports injuries may lead to misdiagnosis and delayed treatment. We herein analyse a case of misdiagnosis of OO of the talus and discuss how to improve the early diagnosis of this rare lesion, thereby permitting rapid treatment.Case presentationA 23-year-old man with a history of left ankle sprains and chronic pain was diagnosed with another ankle sprain and managed conservatively based on normal X-ray findings. After 1 year of recurring pain, he was diagnosed with ankle traumatic arthritis and underwent arthroscopic surgery. His preoperative ankle X-ray findings were still normal, and magnetic resonance imaging at that time demonstrated bone marrow oedema of the left talus. His symptoms reappeared shortly after surgery and progressively worsened. Magnetic resonance imaging performed 3 months after surgery demonstrated widespread bone marrow oedema of the talus. The patient presented to our hospital for pain assessment and was diagnosed with OO of the talus 3 years after his symptoms began. Preoperative computed tomography (CT) demonstrated a typical nidus of OO of the talus. After a second surgery, the patient’s symptoms completely resolved, and pathologic examination confirmed that the lesion was OO. The patient recovered 3 months later and was able to walk normally.ConclusionsOO of the ankle joint exhibits a progressive course and is difficult to diagnose at an early stage. Patients with OO of the talus often have atypical imaging findings, no signs of ankle instability, and no anterior talofibular ligament tenderness. CT is valuable for diagnosing OO, although multiple CT scans may be required to detect the nidus. Proper imaging helps doctors to achieve the correct diagnosis early in the disease course, significantly shortening the treatment cycle and improving the patient’s quality of life.

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“…Arthroscopic excision is another minimally invasive treatment option for intra-articular OO which has shown good clinical results [6, 22–26]. Unlike using percutaneous methods, tumor resection and synovectomy can be performed.…”

Section: Discussionmentioning

confidence: 99%

“…As the talar neck can be easily exposed by arthroscopy, 10.9% of reported cases of talar OO were treated by arthroscopic excision [5]. The only case series about arthroscopic procedures included nine cases with good clinical outcomes, no recurrence, and no pain at a mean follow-up of 6 years [6]. However, due to limited surgical field of view and access for surgical devices, recurrence after incomplete resection with arthroscopy has been reported [7].…”

Section: Discussionmentioning

confidence: 99%

“…The average lag time between symptom onset and a diagnosis of OO in the talus is reportedly 2-3 years [4, 5]. En bloc resection and thermal destruction with laser or radiofrequency ablation under radiological guidance are the most common surgical treatments for OO in the talus [5], although management attempts using arthroscopy were also recently reported [6]. Arthroscopy is technically demanding but has the advantage of being less invasive than arthrotomy; however, the risk of recurrence due to inadequate excision under a limited surgical field of view into the nidus via a small window of the cortex is the greatest concern [7].…”

Section: Introductionmentioning

confidence: 99%

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Anterior Impingement Syndrome of the Ankle Caused by Osteoid Osteoma in the Talar Neck Treated with Arthroscopy and 3D C-Arm-Based Imaging

Ikegami

Matsumoto

Chang

et al. 2017

Case Reports in Orthopedics

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Osteoid osteoma in periarticular lesions tends to have an unusual presentation that likely leads to a delayed or missed diagnosis compared with a typical osteoid osteoma in the metaphysis or diaphysis of the long bone. In cases that are unresponsive to conservative treatment, surgical interventions including en bloc resection, computed tomography-guided percutaneous treatment, and arthroscopic resection have been performed; however, these methods frequently result in inadequate tumor resection and recurrence. Here we present a case of a 16-year-old girl with osteoid osteoma in the talar neck presenting as anterior impingement syndrome due to marked synovitis in the ankle joint which was successfully treated without complications by arthroscopic synovectomy and tumor resection followed by intraoperative 3D C-arm-based imaging confirming complete tumor lesion removal. Her pain was relieved immediately after the surgery, and there was no recurrence at 12 months of follow-up. This is the first case report of the surgical treatment of the osteoid osteoma in the talar neck with the combination methods of arthroscopy and 3D C-arm-based imaging.

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Periarticular Osteoid Osteoma of the Ankle: A Report of Nine Arthroscopically Treated Patients

Cited by 19 publications

References 29 publications

Intra-articular osteoid osteoma as a differential diagnosis of diffuse mono-articular joint pain

Intra-articular osteoid osteoma as a differential diagnosis of diffuse mono-articular joint pain

A misdiagnosed case of osteoid osteoma of the talus: a case report and literature review

Anterior Impingement Syndrome of the Ankle Caused by Osteoid Osteoma in the Talar Neck Treated with Arthroscopy and 3D C-Arm-Based Imaging

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