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01-12-2012 | Pictorial Essay

Osteoid osteomas: a pain in the night diagnosis

Published in: Pediatric Radiology | Issue 12/2012

Abstract

Osteoid osteoma is a common benign bone-forming lesion that is composed of a nidus of vascular osteoid tissue and woven bone lined by osteoblasts. It is frequently associated with considerable surrounding inflammation. The diagnosis is usually straightforward when imaging reveals a radiolucent nidus surrounded by variable degrees of reactive sclerosis. However, the diagnosis can be elusive when osteoid osteomas occur in atypical locations, as they may have a nonspecific and misleading appearance on different imaging modalities, particularly on MRI. The purpose of this pictorial essay is to review the typical and atypical features of osteoid osteomas on different imaging modalities, and the appearance of osteoid osteomas in different locations. We also review growth disturbances caused by osteoid osteomas and potential mimickers, with imaging characteristics that can aid in diagnosis.

Jaffe HL (1935) Osteoid osteoma: a benign osteoblastic tumor composed of osteoid and atypical bone. Arch Surg 31:709–728CrossRef

Kransdorf MJ, Stull MA, Gilkey FW et al (1991) Osteoid osteoma. Radiographics 11:671–696PubMed

Iyer RS, Chapman T, Chew FS (2012) Pediatric bone imaging: diagnostic imaging of osteoid osteoma. AJR 198:1039–1052PubMedCrossRef

Chai JW, Hong SH, Choi J-Y et al (2010) Radiologic diagnosis of osteoid osteoma: from simple to challenging findings. Radiographics 30:737–749, Erratum appears in Radiographics [2010] 30:1156PubMedCrossRef

Swee RG, McLeod RA, Beabout JW (1979) Osteoid osteoma. Detection, diagnosis, and localization. Radiology 130:117–123PubMed

Lindbom A, Lindvall N, Soderberg G et al (1960) Angiography in osteoid osteoma. Acta Radiol 54:327–333PubMedCrossRef

Helms CA, Hattner RS, Vogler JB 3rd (1984) Osteoid osteoma: radionuclide diagnosis. Radiology 151:779–784PubMed

Gil S, Marco SF, Arenas J et al (1999) Doppler duplex color localization of osteoid osteomas. Skeletal Radiol 28:107–110PubMedCrossRef

Ebrahim FS, Jacobson JA, Lin J et al (2001) Intraarticular osteoid osteoma: sonographic findings in three patients with radiographic, CT, and MR imaging correlation. AJR 177:1391–1395PubMed

10.

von Kalle T, Langendörfer M, Fernandez FF et al (2009) Combined dynamic contrast-enhancement and serial 3D-subtraction analysis in magnetic resonance imaging of osteoid osteomas. Eur Radiol 19:2508–2517CrossRef

11.

Mungo DV, Zhang X, O’Keefe RJ et al (2002) COX-1 and COX-2 expression in osteoid osteomas. J Orthop Res 20:159–162PubMedCrossRef

12.

Greco F, Tamburrelli F, Ciabattoni G (1991) Prostaglandins in osteoid osteoma. Int Orthop 15:35–37PubMedCrossRef

13.

Kawaguchi Y, Sato C, Hasegawa T et al (2000) Intraarticular osteoid osteoma associated with synovitis: a possible role of cyclosteoid osteomaxygenase-2 expression by osteoblasts in the nidus. Mod Pathol 13:1086–1091PubMedCrossRef

14.

Kawaguchi Y, Hasegawa T, Oka S et al (2001) Mechanism of intramedullary high intensity area on T2-weighted magnetic resonance imaging in osteoid osteoma: a possible role of COX-2 expression. Pathol Int 51:933–937PubMedCrossRef

15.

Yamamura S, Sato K, Sugiura H et al (1997) Prostaglandin levels of primary bone tumor tissues correlate with peritumoral edema demonstrated by magnetic resonance imaging. Cancer 79:255–261PubMedCrossRef

16.

Ehara S, Rosenthal DI, Aoki J et al (1999) Peritumoral edema in osteoid osteoma on magnetic resonance imaging. Skeletal Radiol 28:265–270PubMedCrossRef

17.

Ekmekci P, Bostanci S, Erdogan N et al (2001) A painless subungual osteoid osteoma. Dermatol Surg 27:764–765PubMedCrossRef

18.

Basu S, Basu P, Dowell JK (1999) Painless osteoid osteoma in a metacarpal. J Hand Surg (Br) 24:133–134CrossRef

19.

Lee EH, Shafi M, Hui JHP (2006) Osteoid osteoma: a current review. J Pediatr Orthop 26:695–700PubMedCrossRef

20.

Kneisl JS, Simon MA (1992) Medical management compared with operative treatment for osteoid-osteoma. J Bone Joint Surg Am 74:179–185PubMed

21.

O’Connell JX, Nanthakumar SS, Nielsen GP et al (1998) Osteoid osteoma: the uniquely innervated bone tumor. Mod Pathol 11:175–180PubMed

22.

Hasegawa T, Hirose T, Sakamoto R et al (1993) Mechanism of pain in osteoid osteomas: an immunohistochemical study. Histopathology 22:487–491PubMedCrossRef

23.

Hukkanen M, Konttinen YT, Santavirta S et al (1993) Rapid proliferation of calcitonin gene-related peptide-immunoreactive nerves during healing of rat tibial fracture suggests neural involvement in bone growth and remodelling. Neuroscience 54:969–979PubMedCrossRef

24.

Kayser F, Resnick D, Haghighi P et al (1998) Evidence of the subperiosteal origin of osteoid osteomas in tubular bones: analysis by CT and MR imaging. AJR 170:609–614PubMed

25.

Hayes CW, Conway WF, Sundaram M (1992) Misleading aggressive MR imaging appearance of some benign musculoskeletal lesions. Radiographics 12:1119–1134, discussion 1135–1136PubMed

26.

Hosalkar HS, Garg S, Moroz L et al (2005) The diagnostic accuracy of MRI versus CT imaging for osteoid osteoma in children. Clin Orthop Relat Res 171–177

27.

Lefton DR, Torrisi JM, Haller JO (2001) Vertebral osteoid osteoma masquerading as a malignant bone or soft-tissue tumor on MRI. Pediatr Radiol 31:72–75PubMedCrossRef

28.

Assoun J, Richardi G, Railhac JJ et al (1994) Osteoid osteoma: MR imaging versus CT. Radiology 191:217–223PubMed

29.

Spouge AR, Thain LM (2000) Osteoid osteoma: MR imaging revisited. Clin Imaging 24:19–27PubMedCrossRef

30.

Liu PT, Chivers FS, Roberts CC et al (2003) Imaging of osteoid osteoma with dynamic gadolinium-enhanced MR imaging. Radiology 227:691–700PubMedCrossRef

31.

Gaeta M, Minutoli F, Pandolfo I et al (2004) Magnetic resonance imaging findings of osteoid osteoma of the proximal femur. Eur Radiol 14:1582–1589PubMedCrossRef

32.

Liu PT, Kujak JL, Roberts CC et al (2011) The vascular grosteoid osteomave sign: a new CT finding associated with osteoid osteomas. AJR 196:168–173PubMedCrossRef

33.

Yaniv G, Shabshin N, Sharon M et al (2011) Osteoid osteoma—the CT vessel sign. Skeletal Radiol 40:1311–1314PubMedCrossRef

34.

Epelman M, Jaramillo D, Hosalkar HS et al (2008) Usefulness of the “hypointense halo sign” in the MRI diagnosis of osteoid osteoma. Pediatr Radiol 38(Suppl 2):S296

35.

Allen SD, Saifuddin A (2003) Imaging of intra-articular osteoid osteoma. Clin Radiol 58:845–852PubMedCrossRef

36.

Snarr JW, Abell MR, Martel W (1973) Lymphofollicular synovitis with osteoid osteoma. Radiology 106:557–560PubMed

37.

Hudson TM, Hawkins IF (1981) Radiologic evaluation of chondroblastoma. Radiology 139:1–10PubMed

38.

Levine SM, Lambiase RE, Petchprapa CN (2003) Cortical lesions of the tibia. Radiographics 23:157–177PubMedCrossRef

39.

Rosenthal DI, Hornicek FJ, Torriani M et al (2003) Osteoid osteoma: percutaneous treatment with radiofrequency energy. Radiology 229:171–175PubMedCrossRef

40.

Shinozaki T, Sato J, Watanabe H et al (2005) Osteoid osteoma treated with computed tomography-guided percuteneous radiofrequency ablation: a case series. J Orthop Surg 13:317–322

41.

Montamedi D, Learch TJ, Ishimitsu DN et al (2009) Thermal ablation of osteoid osteoma: overview and step-by-step guide. Radiographics 29:2127–2141CrossRef

42.

Tillotson CL, Rosenberg AE, Rosenthal DI (1989) Controlled thermal injury of bone: report of a percutaneous technique using radiofrequency electrode and generator. Invest Radiol 24:888–892PubMedCrossRef

Title: Osteoid osteomas: a pain in the night diagnosis
Publication date: 01-12-2012
Published in: Pediatric Radiology / Issue 12/2012
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI: https://doi.org/10.1007/s00247-012-2495-y

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