Osteoid Osteoma: typical and atypical radiological findings

Congress:

ECR 2018

Poster Number:

C-2922

Type:

Educational Exhibit

Keywords:

Bones, Extremities, Musculoskeletal bone, CT, MR, Conventional radiography, Diagnostic procedure, Education and training

Authors:

F. Barbiera¹, E. Murmura¹, B. Murmura², M. Accardi¹, A. Botta¹, A. Aiello¹, T. smeraldi², L. La Grutta², R. Lagalla²; ¹Sciacca/IT, ²Palermo/IT

DOI:

10.1594/ecr2018/C-2922

DOI-Link:

https://dx.doi.org/10.1594/ecr2018/C-2922

Fig. 1: Osteoid osteoma of the cervical spine in a 26 years old female (a) sagittal,...

Fig. 2: Intra-articular Osteoid osteoma of right femoral neck in a 25 years old man. CT...

Fig. 3: A) Plain radiography of the right ankle: a sclerotic lesion of subtalar...

Fig. 4: A) Plain radiography of the left hip reveals a small radiolucent nidus in the...

Learning objectives

To describe radiologic findings of osteoid osteoma, in particular atypical findings, and its variants and mimics.

Background

Osteoid osteoma is a small spherical tumor with a diameter of 2 cm or less, composed of a central zone named nidus which is an atypical bone completely enclosed within a well-vascularized stroma (1). The peripheral sclerotic reaction zone is composed of osteoblasts, osteoclasts and dilated capillaries surrounding the nidus. Peripheral nerve fibers are abundant in and around an osteoid osteoma. Pain is typically at night and it is promptly relieved by the administration of salicylates. Tumors are classified as cortical, medullary or subperiosteal on...

Findings and procedure details

Typical radiographic findings: In plain radiographs the lesion is characterized by a small nidus surrounded by dense bone; the nidus is mostly seen as a radiolucent area significantly or mildly calcified depending on the disease duration (1). At CT, the nidus is well defined and round or oval with low attenuation. An area of hypoattenuation may be seen centrally with a peripheral reactive sclerosis (3). At MRI, the nidus has low to intermediate signal intensity on T1-weighted images and variable signal intensity on T2-weighted images...

Conclusion

To make the correct diagnosis, it is important to be familiar with the radiologic findings of osteoid osteoma, its mimics and confusing imaging findings.

Personal information

Dr. Filippo Barbiera UO Radiologia - Ospedale "Giovanni Paolo II" - Sciacca - ASP AG2 - Via Pompei, 92019 Sciacca AG Email:[email protected] Dr. Bruno Murmura Resident in training. Università degli Studi di Palermo - DiBiMed - Scienze radiologiche - Policlinico Universitario A.O.U.P. - Via del Vespro, 129 Palermo Email:[email protected]

References

1. Hashemi J, Gharahdaghi M, Ansaripour E, Jedi F, Hashemi S. Radiological Features of Osteoid Osteoma: Pictorial Review. Iran J Radiol. 2011;8(3):182-189. DOI:0.5812/kmp.iranjradiol.17351065.3392 2. Chai JW, Hong SH, Choi JY, Koh YH, Lee JW, Choi JA, Kang HS, Radiologic Diagnosis of Osteoid Osteoma: From Simple to Challenging Findings. RadioGraphics May 2010 Volume 30 Issue 3. http://pubs.rsna.org/doi/full/10.1148/rg.303095120# 3. Gamba JL, Martinez S, Apple J, Harrelson JM, Nunley JA. Computed tomography of axial skeletal osteoid osteomas. AJR Am J Roentgenol 1984;142 (4):769–772. 4. Resnick D, Kyrriakos M,...