title: Clinical and radiological features and skeletal sequelae in childhood intra-/juxta-articular versus extra-articular osteoid osteoma.
abstract: BACKGROUND
  To compare the clinical and radiological features of intra-/juxta-articular osteoid osteoma and extra-articular osteoid osteoma in skeletally immature patients, paying special attention to the skeletal complications.
  
  
  METHODS
  Osteoid osteoma in 34 children (22 boys and 12 girls, mean age 10.4 years) was dichotomized according to the location of the nidus as intra-/juxta-articular (11 children) or extra-articular (23 children). The following features were compared: diagnostic delay, typical symptoms, synovitis and limited range of joint motion, response to treatment, typical radiographic findings, and skeletal complications.
  
  
  RESULTS
  Eight of the 11 children with intra-/juxta-articular osteoid osteoma presented with synovitis in the involved joint, which led to a delayed diagnosis for a median 9.5 months. Pain disappeared in all children with surgical or medical interventions, but at the mean 4.9-year follow-up evaluation, skeletal abnormalities around the joint were noted in 5 children (4 proximal femur and 1 distal humerus) with intra-/juxta-articular osteoid osteoma, 2 of whom required subsequent surgeries for limited hip motion caused by femoroacetabular impingement and limited range of elbow motion, respectively. In contrast, typical clinical and radiological features were observed more often in extra-articular osteoid osteoma, and only 1 child showed overgrowth of the tibia, which did not have clinical significance.
  
  
  CONCLUSIONS
  Intra-/juxta-articular osteoid osteomas in growing children exhibit different clinical and radiological features from extra-articular lesions. Skeletal abnormalities mainly develop in intra-/juxta-articular osteoid osteoma, and these may lead to permanent skeletal sequelae.
authors: Department of Orthopedic Surgery, Jeju National University Hospital, Jeju, South Korea. wwiiw82@snu.ac.kr.
authors: Mi Hyun
authors: MH
authors: Song
authors: Department of Orthopedic Surgery, Seoul National University Children's Hospital, 101 Daehak-ro, Jongno-gu, 110-744, Seoul, South Korea. yoowj@snu.ac.kr.
authors: Won Joon
authors: WJ
authors: Yoo
authors: Department of Orthopedic Surgery, Seoul National University Children's Hospital, 101 Daehak-ro, Jongno-gu, 110-744, Seoul, South Korea. tjcho@snu.ac.kr.
authors: Tae-Joon
authors: TJ
authors: Cho
authors: Department of Orthopedic Surgery, Seoul National University Bundang Hospital, 82 Gumi-ro, 173 Beon-gil, Bundang-gu, Kyunggi-do, 463-707, South Korea. chin@snu.ac.kr.
authors: Chin Youb
authors: CY
authors: Chung
authors: Department of Orthopedic Surgery, Seoul National University Bundang Hospital, 82 Gumi-ro, 173 Beon-gil, Bundang-gu, Kyunggi-do, 463-707, South Korea. pmsmed@gmail.com.
authors: Moon Seok
authors: MS
authors: Park
authors: Department of Pediatric Radiology, Seoul National University Children's Hospital, 101 Daehak-ro, Jongno-gu, 110-744, Seoul, South Korea. cheonje@snu.ac.kr.
authors: Jung-Eun
authors: JE
authors: Cheon
authors: Department of Orthopedic Surgery, Seoul National University Children's Hospital, 101 Daehak-ro, Jongno-gu, 110-744, Seoul, South Korea. inhoc@snu.ac.kr.
authors: In Ho
authors: IH
authors: Choi
mesh_terms: D000293:Adolescent; D001859:Bone Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D057210:Delayed Diagnosis; D003937:Diagnosis, Differential; D004551:Elbow Joint / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010017:Osteoma, Osteoid / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D016059:Range of Motion, Articular; D013585:Synovitis / Q000175:diagnosis; D014057:Tomography, X-Ray Computed
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