OSTEOID OSTEOMA
 
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OSTEOID OSTEOMA

 

DEFINITION:

A benign osteogenic tumor of bone characterized by a mass and pain.

EPIDEMIOLOGY:

  • incidence: ?
  • age of onset:
    • peak between 10-20 years; does occur before age 10
  • risk factors:
    • M > F (3:1)

PATHOGENESIS:

1. Tumor Origin

1. Major

  • proximal femur (neck, greater trochanter), vertebrae (pedicles, facets, spinous processes), proximal tibia

2. Histiologic Type

1. Osteogenic Cells

  • benign and do not metastasize

3. Other Benign Bone Tumors

  • Benign Cortical Defects
  • Enchondroma
  • Non-Ossifying Fibroma
  • OSTEOID OSTEOMA
  • Solitary Cysts

CLINICAL FEATURES:

1. Primary Tumor

1. Femur/Tibia

1. Pain

  • hip pain and/or knee pain
  • insidious onset
  • worse at night and with weight bearing
  • very responsive to ASA and NSAID
  • deep and penetrating ache
  • associated symptoms
    • limp with muscle atrophy and weakness
    • local swelling around site
    • joint effusion

2. Vertebrae

1. Back Pain

  • as above and associated with scoliosis

INVESTIGATIONS:

1. Imaging Studies

1. Skeletal X-Ray/CT

  • typical lesion: nidus of increased density surrounded by a ring of decreased density that is surrounded by bone of increased density

2. Bone Scan

  • increased uptake of technetium

2. Pathology

1. Tumor

  • nidus composed of a mixture of osteoid bone & blood vessels that is surrounded by a fibrovascular layer completely separating it from the surrounding sclerotic bone

3. Biologic

  • no abnormality in inflammatory indices

MANAGEMENT:

1. Surgery

  • excision (recurrences rare)

 

 

Pediatric Database - OSTEOID OSTEOMA

 

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