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Osteoid osteoma of scaphoid
1Department of Orthopaedics, Maulana Azad Medical College and Associated Hospitals, New Delhi, India. drvishalgarg@rediffmail.com
Journal of the Southern Orthopaedic Association
|October 28, 2003
Summary
Osteoid osteoma, a benign bone tumor, can occur in the hand, presenting with vague symptoms. Early CT diagnosis and surgical removal of the nidus effectively resolved wrist pain and swelling in a teenage patient.
Area of Science:
- Orthopedic Surgery
- Radiology
- Pediatric Oncology
Background:
- Osteoid osteoma is a benign bone-forming tumor, typically affecting long bones, but rarely found in the hand.
- Nonspecific initial symptoms can delay diagnosis, leading to prolonged patient suffering and misdiagnosis.
Observation:
- A 14-year-old male presented with two months of spontaneous wrist swelling and pain.
- Initial radiography showed a sclerotic lesion in the scaphoid bone, with normal sedimentation rate, prompting suspicion of other conditions like tuberculosis.
- A computed tomography (CT) scan of the wrist revealed the characteristic double-ring sign, pathognomonic for osteoid osteoma.
Findings:
- The osteoid osteoma nidus within the scaphoid bone was surgically excised via curettage.
- Post-operative recovery was marked by rapid and complete resolution of the patient's wrist pain and swelling.
Implications:
- This case highlights the importance of considering osteoid osteoma in the differential diagnosis of wrist pain, even with atypical localization.
- Advanced imaging, particularly CT scans, is crucial for accurate diagnosis of osteoid osteoma by visualizing the double-ring sign.
- Surgical excision of the nidus provides an effective and curative treatment for symptomatic osteoid osteomas in the hand, leading to excellent functional outcomes.
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