Juxta-articular osteoid osteoma.
Osteoid osteomas that arise at the end of a long bone, within the insertion of the joint capsule (juxta-articular, intra-articular), may cause misleading clinical, radiographic, and histologic findings, resulting in unnecessary diagnostic tests and a delay in definitive treatment. To clarify optimum diagnostic procedures, we reviewed 20 cases of juxta-articular osteoid osteomas and found a mean delay from presentation to correct diagnosis of 24 months. Plain radiographs were either negative or showed only secondary changes. A periosteal reaction and proliferative synovitis with chronic inflammation was common, which could be misinterpreted as rheumatoid arthritis. Optimum diagnostic procedures were a bone scan followed by plain tomograms and an excisional biopsy of the nidus.
Bauer
T W
TW
Department of Pathology, Cleveland Clinic Foundation, OH 44195.
Zehr
R J
RJ
Belhobek
G H
GH
Marks
K E
KE
D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology*; D002648:Child; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D010017:Osteoma, Osteoid / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology*; D014054:Tomography; D014057:Tomography, X-Ray Computed