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



We 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.



Out 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.



Rarely, 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.
Department of Osteology and Biomechanics, University Medical Centre Hamburg-Eppendorf, Lottestr. 59, Hamburg, 22529, Germany. t.rolvien@uke.de.
Tim
T
Rolvien
Department of Osteology and Biomechanics, University Medical Centre Hamburg-Eppendorf, Lottestr. 59, Hamburg, 22529, Germany.
Jozef
J
Zustin
Department of Osteology and Biomechanics, University Medical Centre Hamburg-Eppendorf, Lottestr. 59, Hamburg, 22529, Germany.
Haider
H
Mussawy
Department of Osteology and Biomechanics, University Medical Centre Hamburg-Eppendorf, Lottestr. 59, Hamburg, 22529, Germany.
Tobias
T
Schmidt
Department of Osteology and Biomechanics, University Medical Centre Hamburg-Eppendorf, Lottestr. 59, Hamburg, 22529, Germany.
Pia
P
Pogoda
Department of Osteology and Biomechanics, University Medical Centre Hamburg-Eppendorf, Lottestr. 59, Hamburg, 22529, Germany.|MW Centre for Orthopaedics and Sports Medicine, Munich, Germany.
Peter
P
Ueblacker
D000328:Adult; D018771:Arthralgia / Q000209:etiology*; D003937:Diagnosis, Differential; D005260:Female; D005266:Femoral Neoplasms / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D008297:Male; D010017:Osteoma, Osteoid / Q000150:complications / Q000175:diagnosis*; D012189:Retrospective Studies; D013125:Spinal Neoplasms / Q000150:complications / Q000175:diagnosis*; D055815:Young Adult
Bone tumour; Differential diagnosis; Imaging; Intra-articular osteoid osteoma; Joint pain