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Safe surgical hip dislocation for acetabular osteoid osteoma excision.

Sujit Tripathy1, Paulson Varghese2, Siddharth Sekhar Sethy2

  • 1Department of Orthopaedics, AIIMS, Bhubaneswar, Odisha, India ortho_sujit@aiimsbhubaneswar.edu.in.

BMJ Case Reports
|March 1, 2022
PubMed
Summary

This study details the successful surgical excision of a rare acetabular osteoid osteoma in a child. The minimally invasive technique ensured complete tumor removal and a full recovery, resolving hip pain and mobility issues.

Keywords:
musculoskeletal and joint disordersorthopaedicsradiology

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Area of Science:

  • Orthopedic Surgery
  • Pediatric Oncology
  • Radiology

Background:

  • Osteoid osteoma is a benign bone tumor that can cause significant pain, particularly in pediatric patients.
  • Acetabular osteoid osteomas present unique surgical challenges due to their location within the hip joint.
  • Accurate preoperative imaging is crucial for surgical planning and successful excision.

Observation:

  • A 9-year-old girl presented with nocturnal hip pain, limp, and restricted movement.
  • Imaging revealed a 0.7 cm osteoid osteoma nidus in the quadrilateral plate of the acetabulum.
  • The lesion was located centrally within the cancellous bone, inferior to the triradiate cartilage.

Findings:

  • Surgical dislocation of the hip facilitated access to the acetabular lesion.
  • Preoperative CT measurements and intraoperative fluoroscopy guided the precise localization and excision.
  • Complete removal of the nidus with its sclerotic rim was achieved.
  • Postoperative imaging confirmed successful tumor excision.

Implications:

  • Safe surgical dislocation of the hip is a viable approach for acetabular osteoid osteomas.
  • Complete excision leads to resolution of pain and restoration of hip function.
  • This case highlights the importance of multidisciplinary imaging and surgical expertise in managing rare pediatric bone tumors.