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Intra-articular osteoid osteoma mimicking juvenile arthritis.

Traore SY, Dumitriu DI, Docquier PL - Case Rep Orthop (2014)

Bottom Line: In case of intra-articular osteoid osteoma, misdiagnosis as juvenile arthritis may occur, delaying adequate treatment.We report cases of intra-articular osteoid osteomas in children that were misdiagnosed and initially inappropriately treated with intra-articular corticoid injection.Clinicians and radiologists should be aware of the potentially confusing clinical and imaging findings associated with intra-articular osteoid osteoma.

View Article: PubMed Central - PubMed

Affiliation: Computer Assisted Robotic Surgery (CARS), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Tour Pasteur +4, Avenue Mounier 53, 1200 Brussels, Belgium ; Service de Chirurgie Orthopédique et Traumatologique, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels, Belgium.

ABSTRACT
In case of intra-articular osteoid osteoma, misdiagnosis as juvenile arthritis may occur, delaying adequate treatment. We report cases of intra-articular osteoid osteomas in children that were misdiagnosed and initially inappropriately treated with intra-articular corticoid injection. Diagnosis of osteoid osteoma was finally given by CT-scan and appropriate treatment by radiofrequency ablation or surgical ablation was performed. Clinicians and radiologists should be aware of the potentially confusing clinical and imaging findings associated with intra-articular osteoid osteoma.

No MeSH data available.


Related in: MedlinePlus

Same patient as in Figure 1. (a) A repeated frontal X-ray of the right hip, performed six months later, demonstrates a radiolucent nidus of femoral neck. (b) Confirmation was obtained by CT-scan.
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fig2: Same patient as in Figure 1. (a) A repeated frontal X-ray of the right hip, performed six months later, demonstrates a radiolucent nidus of femoral neck. (b) Confirmation was obtained by CT-scan.

Mentions: Because of pain persistence 6 weeks later, she consulted our clinic for a second opinion. She had a painful range of motion limitation of the right hip. Hip radiography, hip echography, and bone scan were performed (Figure 1). Borrelia, Mycoplasma, and Chlamydia serologies were negative, as well as Rose-Waaler test (passive hemagglutination test for rheumatoid factor in the serum), latex agglutination test for rheumatoid factor, and HLA B27 test. Bone scan showed joint hyperfixation. The rheumatologist retained the diagnosis of monoarticular juvenile arthritis. A treatment by intra-articular methylprednisolone acetate injection under general anesthesia was performed but without symptoms improvement. One week later, she was reviewed with persistence of pain. A CT-scan and a new radiograph were performed (Figure 2). These exams confirmed OO diagnosis with a nidus of 5.5 mm in the femoral neck. The diagnosis was made with a delay of six months from the first consultation. A radiofrequency ablation was performed with good resolution of pain and recovery of a normal hip range of motion.


Intra-articular osteoid osteoma mimicking juvenile arthritis.

Traore SY, Dumitriu DI, Docquier PL - Case Rep Orthop (2014)

Same patient as in Figure 1. (a) A repeated frontal X-ray of the right hip, performed six months later, demonstrates a radiolucent nidus of femoral neck. (b) Confirmation was obtained by CT-scan.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4127225&req=5

fig2: Same patient as in Figure 1. (a) A repeated frontal X-ray of the right hip, performed six months later, demonstrates a radiolucent nidus of femoral neck. (b) Confirmation was obtained by CT-scan.
Mentions: Because of pain persistence 6 weeks later, she consulted our clinic for a second opinion. She had a painful range of motion limitation of the right hip. Hip radiography, hip echography, and bone scan were performed (Figure 1). Borrelia, Mycoplasma, and Chlamydia serologies were negative, as well as Rose-Waaler test (passive hemagglutination test for rheumatoid factor in the serum), latex agglutination test for rheumatoid factor, and HLA B27 test. Bone scan showed joint hyperfixation. The rheumatologist retained the diagnosis of monoarticular juvenile arthritis. A treatment by intra-articular methylprednisolone acetate injection under general anesthesia was performed but without symptoms improvement. One week later, she was reviewed with persistence of pain. A CT-scan and a new radiograph were performed (Figure 2). These exams confirmed OO diagnosis with a nidus of 5.5 mm in the femoral neck. The diagnosis was made with a delay of six months from the first consultation. A radiofrequency ablation was performed with good resolution of pain and recovery of a normal hip range of motion.

Bottom Line: In case of intra-articular osteoid osteoma, misdiagnosis as juvenile arthritis may occur, delaying adequate treatment.We report cases of intra-articular osteoid osteomas in children that were misdiagnosed and initially inappropriately treated with intra-articular corticoid injection.Clinicians and radiologists should be aware of the potentially confusing clinical and imaging findings associated with intra-articular osteoid osteoma.

View Article: PubMed Central - PubMed

Affiliation: Computer Assisted Robotic Surgery (CARS), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Tour Pasteur +4, Avenue Mounier 53, 1200 Brussels, Belgium ; Service de Chirurgie Orthopédique et Traumatologique, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels, Belgium.

ABSTRACT
In case of intra-articular osteoid osteoma, misdiagnosis as juvenile arthritis may occur, delaying adequate treatment. We report cases of intra-articular osteoid osteomas in children that were misdiagnosed and initially inappropriately treated with intra-articular corticoid injection. Diagnosis of osteoid osteoma was finally given by CT-scan and appropriate treatment by radiofrequency ablation or surgical ablation was performed. Clinicians and radiologists should be aware of the potentially confusing clinical and imaging findings associated with intra-articular osteoid osteoma.

No MeSH data available.


Related in: MedlinePlus