[Too young for a twisted painful back].
One girl aged 13 years and 2 boys aged 18 and 14 years had a painful scoliosis. Plain radiographs, blood tests and MRI revealed no abnormalities. Bone scintigraphy and CT scans were needed to establish the diagnosis 'osteoid osteoma'. In the girl, the initial CT scan was also negative and the tumours could only be found after using thin slices. She had had the complaints for 6 months and both boys had had the complaints for more than a year, before the diagnosis was made. They all made a complete recovery after surgical resection. A chronic painful back in young patients is often caused by structural deformities. The differential diagnosis also includes an osteoid osteoma. If an osteoid osteoma is suspected, then after radiographs, bone scintigraphy is indicated, which if necessary can be followed up with targeted CT scans.
Henkus
H E
HE
Afd. Orthopedie, Medisch Centrum Haaglanden, locatie Westeinde, Postbus 432, 2501 CK Den Haag. hhenkus@planet.nl
Bessems
J H J M
JH
Wurzer
J A L
JA
de Lange
S
S
D000293:Adolescent; D001416:Back Pain / Q000209:etiology*; D001859:Bone Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010017:Osteoma, Osteoid / Q000175:diagnosis* / Q000000981:diagnostic imaging; D011877:Radionuclide Imaging; D012600:Scoliosis / Q000175:diagnosis* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome