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Osteoid osteoma

Muncy TAM - MedPix (2006)

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Osteoid osteoma

History: 29-year-old man with 3 year history of gradually worsening right medial thigh pain, eventually requiring the use of crutches for ambulation. Pain was worse at night, but never woke him from sleep. NSAIDs provided temporary relief of symptoms.

Findings: AP and lateral (lateral not shown) radiographs of the right femur demonstrated a zone of cortical thickening with a smooth contour along the medial aspect of the distal right femoral metadiaphysis (Fig 1). A central lucency measuring 2.5 cm craniocaudal can be seen with a small component of associated cortical penetration. No surrounding soft tissue abnormalities were evident. MR T1 coronal image (Fig. 2) demonstrates the wide cortical thickening with associated cortical penetration. Follow-up MR imaging validated the cortical thickening as low signal intensity. On T2-weighted images a nidus in the mid femoral shaft was noted with high signal intensity and enhancement following administration of intravenous gadolinium (Figs. 3&4). There is marked bone production medially, with adjacent bone marrow edema involving the mid femoral shaft. Nuclear medicine bone scan (Fig. 5)reveals intense focal uptake eccentrically in the right distal third of the femur.

Ddx: Stress fracture Fibrous dysplasia Chronic osteomyelitis Osteosarcoma Brodie's abscess Bone island Osteoblastoma

Dxhow: Radiogaphic findings and clinical presentation

Exam: Physical exam revealed moderate tenderness to palpation over the right medial mid-thigh, and a 2-3 cm deep, firm, non-mobile mass palpable in the same region. The patient demonstrated full range of motion of his right lower extremity, however, pain was exacerbated by forced extension of the right knee.

No MeSH data available.


Fig. 5. Nuclear Medicine Bone Scan with Tc 99m HDP shows intense uptake of radiopharmaceutical in the lower right femur.
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MPX1503_synpic29646: Fig. 5. Nuclear Medicine Bone Scan with Tc 99m HDP shows intense uptake of radiopharmaceutical in the lower right femur.


Osteoid osteoma

Muncy TAM - MedPix (2006)

Fig. 5. Nuclear Medicine Bone Scan with Tc 99m HDP shows intense uptake of radiopharmaceutical in the lower right femur.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX1503&req=5

MPX1503_synpic29646: Fig. 5. Nuclear Medicine Bone Scan with Tc 99m HDP shows intense uptake of radiopharmaceutical in the lower right femur.

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Osteoid osteoma

History: 29-year-old man with 3 year history of gradually worsening right medial thigh pain, eventually requiring the use of crutches for ambulation. Pain was worse at night, but never woke him from sleep. NSAIDs provided temporary relief of symptoms.

Findings: AP and lateral (lateral not shown) radiographs of the right femur demonstrated a zone of cortical thickening with a smooth contour along the medial aspect of the distal right femoral metadiaphysis (Fig 1). A central lucency measuring 2.5 cm craniocaudal can be seen with a small component of associated cortical penetration. No surrounding soft tissue abnormalities were evident. MR T1 coronal image (Fig. 2) demonstrates the wide cortical thickening with associated cortical penetration. Follow-up MR imaging validated the cortical thickening as low signal intensity. On T2-weighted images a nidus in the mid femoral shaft was noted with high signal intensity and enhancement following administration of intravenous gadolinium (Figs. 3&4). There is marked bone production medially, with adjacent bone marrow edema involving the mid femoral shaft. Nuclear medicine bone scan (Fig. 5)reveals intense focal uptake eccentrically in the right distal third of the femur.

Ddx: Stress fracture Fibrous dysplasia Chronic osteomyelitis Osteosarcoma Brodie's abscess Bone island Osteoblastoma

Dxhow: Radiogaphic findings and clinical presentation

Exam: Physical exam revealed moderate tenderness to palpation over the right medial mid-thigh, and a 2-3 cm deep, firm, non-mobile mass palpable in the same region. The patient demonstrated full range of motion of his right lower extremity, however, pain was exacerbated by forced extension of the right knee.

No MeSH data available.