Osteoid Osteoma in an Elderly Patient: Diagnostic Challenges

Area of Science:

• Orthopedic Surgery
• Oncology
• Pathology

Background:

• Osteoid osteoma is a benign bone tumor typically affecting young individuals.
• Classic presentation includes nocturnal pain relieved by NSAIDs and radiographic findings of a nidus with sclerosis.
• Occurrence in elderly patients is rare, and symptoms can mimic other conditions like osteoarthritis.

Purpose of the Study:

• To report a rare case of osteoid osteoma in an elderly patient.
• To highlight the diagnostic challenges and atypical presentation in this demographic.
• To emphasize the importance of histopathological examination in confirming the diagnosis.

Main Methods:

• Case presentation of a 70-year-old female with persistent hip pain.
• Review of preoperative imaging (inconclusive for a definitive lesion).
• Histopathological examination of the total hip arthroplasty specimen.

Main Results:

• The patient underwent total hip arthroplasty for presumed arthritis.
• Preoperative imaging showed edema and degenerative changes, not a clear osteoid osteoma.
• Histopathology confirmed a nodule consistent with osteoid osteoma within the arthroplasty specimen.

Conclusions:

• Osteoid osteoma can present atypically in elderly patients, mimicking osteoarthritis.
• Diagnostic challenges exist due to non-specific symptoms and imaging findings.
• Histopathological analysis is crucial for definitive diagnosis in suspected cases, especially when initial imaging is inconclusive.