Related Experiment Videos
Diagnosis of osteoid osteoma in the child
M Kaweblum1, W B Lehman, J Bash
1Pediatric Orthopaedic Department, Hospital for Joint Diseases Orthopaedic Institute, New York, New York.
Insights
Diagnosing osteoid osteoma in young children is challenging due to subtle symptoms and overlapping conditions. Technetium bone scans and computerized tomography (CT) are effective diagnostic tools for this bone tumor.
Area of Science:
- Pediatric Orthopedics
- Skeletal Radiology
- Pediatric Oncology
Background:
- Osteoid osteoma is a benign bone tumor that can present with diagnostic challenges in young children.
- Early diagnosis is crucial to prevent complications such as bone deformities and leg-length discrepancies.
Purpose of the Study:
- To review clinical and radiologic diagnostic challenges of osteoid osteoma in children under 5 years of age.
- To evaluate the efficacy of advanced imaging techniques in diagnosing osteoid osteoma in this age group.
Main Methods:
- Retrospective review of 52 English literature cases and 7 cases from the Hospital for Joint Diseases.
- Analysis of clinical manifestations, radiographic findings, technetium bone scans, and computerized tomography (CT) scans.
Main Results:
- Pain was the most frequent symptom, but absent in 12% of cases. Limp, tenderness, swelling, and atrophy were also noted.
- Standard radiography was often inconclusive; technetium bone scans and CT scans demonstrated high efficacy in tumor identification and localization.
- Over 25% of cases exhibited bone deformities and leg-length discrepancies.
Conclusions:
- Osteoid osteoma diagnosis in young children, especially those beginning to walk, requires a high index of suspicion.
- Advanced imaging like technetium bone scans and CT are invaluable for accurate diagnosis when standard radiographs are negative.
- Mini-block excision is recommended upon diagnosis to prevent long-term complications.
Abstract:
Fifty-two cases of osteoid osteoma in children under 5 years of age were collected from the English literature and reviewed, along with seven cases from the Hospital for Joint Diseases. Analytic emphasis was placed on the clinical and radiologic difficulties encountered in the diagnosis of osteoid osteoma in children. Diagnosis is especially challenging in patients that are just beginning to walk. Osteoid osteoma is often confused with many other entities. Although pain was the most frequent clinical manifestation, it was absent in 12% of cases; limp tenderness, swelling, and atrophy were the next most frequent findings. When standard radiographic findings proved negative for this condition, technetium bone scans were of considerable efficacy in identifying the tumor. When used, computerized tomograms permitted visualization and precise localization of the tumors in all cases. Bone deformities and leg-length discrepancies were found in more than 25% of the cases. Mini-block excision is recommended at diagnosis.