Neurological manifestations ofosteoid osteoma

Theclinical andradiological features of38 children withosteoid osteomas were analysed retrospectively. Twentyninepatients had lesions ofthefemur(n=17) or tibia (n=12). Themean duration fromtheonsetofsymptomstodiagnosis was 13-8months. Inseven patients thehistory ofpainandabnormalities on examination suggested a possible neurological disorder. Fourteen of29patients (48%) withfemoral ortibial osteomashadlocalised muscleatrophy, and10patients (34%)had diminished orabsent deeptendon reflexes in theaffected limb. Twopatients hadpainless lesions. Sixpatients hadnormalplain radiographs. Delayinthediagnosis ofosteoid osteomamay beprevented bytheknowledge that pain may bereferred orradicular, that the concomitant occurrence ofmuscleatrophy anddepressed deeptendonreflexes are relatively common findings, andthatthe characteristic radiological features may only appearlateinthecourse ofthedisease.