Intra-articular osteoid osteoma in the proximal tibia and its imaging characteristics.
Due to mostly non-specific clinical symptoms and variable appearance on magnetic resonance imaging (MRI), the diagnosis of an intra-articular osteoid osteoma (iaOO) is often delayed. We report the case of a 26-year-old male with an atypical clinical manifestation of an iaOO in the proximal tibia and its MRI specific characteristics of tumor progression. The patient presented to our clinic after receiving multiple unsuccessful conservative and surgical interventions due to anterior knee pain, which persisted for 12months. Prior to the correct diagnosis of iaOO manifestation, the patient was subjected to multiple steroid infiltrations and two arthroscopies including partial meniscal resection. Due to increasing complaints, meniscal transplantation, bone decompression and/or ACL reconstruction were recommended. Subsequent computer tomography (CT) scanning and successful test medication with salicylates (ASS) confirmed iaOO presentation. Only after arthroscopic tumor resection was the patient symptom free at three months of follow-up. The present description of MRI specific characteristics of iaOO progression has the potential to accelerate correct tumor detection in the future.
Department of Trauma and Reconstructive Surgery, Asklepios Clinic St. Georg, Lohmühlenstr. 5, 20099, Hamburg, Germany; Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 52, 22529 Hamburg, Germany. Electronic address: matkrause@me.com.
Matthias
M
Krause
Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 52, 22529 Hamburg, Germany. Electronic address: r.oheim@uke.de.
Ralf
R
Oheim
Department of Trauma and Reconstructive Surgery, Asklepios Clinic St. Georg, Lohmühlenstr. 5, 20099, Hamburg, Germany. Electronic address: meenen@me.com.
Norbert M
NM
Meenen
Department of Trauma and Reconstructive Surgery, Asklepios Clinic St. Georg, Lohmühlenstr. 5, 20099, Hamburg, Germany. Electronic address: k.frosch@asklepios.com.
Karl-Heinz
KH
Frosch
Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 52, 22529 Hamburg, Germany. Electronic address: amling@uke.de.
Michael
M
Amling
D000328:Adult; D001182:Arthroscopy; D001859:Bone Neoplasms / Q000000981:diagnostic imaging*; D057210:Delayed Diagnosis; D003951:Diagnostic Errors; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging; D008297:Male; D010017:Osteoma, Osteoid / Q000000981:diagnostic imaging*; D012086:Reoperation; D013977:Tibia / Q000000981:diagnostic imaging* / Q000601:surgery; D014057:Tomography, X-Ray Computed
Arthroscopy; Intra-articular osteoid osteoma; Magnetic resonance imaging; Proximal tibia