Osteoid Osteoma of a Mecacarpal Bone: Case Report

A 16-year-old girl presented to our clinic with a nocturnally aggravating pain on her 5th metacarpal bone for approximately one year, which responded well to salicylate medication. Clinical diagnosis of our case was achieved through anamnesis, physical examination, and imaging studies. In plane X-Ray, increased sclerosis in middle 1/3 of the 5th metacarpal bone extending from cortical area to medulla was observed. MRI revealed an intracortical lesion surrounded by increased sclerotic tissue. History of nocturnally aggravating and salicylateresponding pain made us suspect osteoid osteoma for diagnosis. After curettage of the area we thought as nidus, autografting was performed. After excisional biopsy, histopathological examination confirmed the diagnosis. In our case, we would like to draw attention for the fact that although being a rare localization, osteoid osteoma should be kept in mind in patients with nocturnally aggravating and salicylate-responding pain in metacarpal region, where radiological studies showed an intracortical lesion. On alti yasindaki bayan olgumuz besinci metakarp uzerinde yaklasik bir senedir geceleri artan, salisilatlara cevap veren agri sikayeti ile poliklinigimize basvurdu. Olgumuzda taniya anamnez, klinik muayene ve goruntuleme yontemleri ile ulasildi. Eksizyonel biyopsi yapilan hastada kuretaj sonrasinda otogreft ile greftleme islemi yapildi. Direkt grafide besinci metakarp 1/3 orta bolumde korteksten medulla icine kadar uzanan skleroz artisi tespit edildi ve sonrasinda manyetik rezonans goruntuleme yapildi. Manyetik rezonans goruntulemede intrakortikal lezyon varligi ile etrafindaki sklerotik dokunun artisi ve klinik olarak geceleri artip, salisilatlara cevap veren agrinin olmasi on tani olarak bizi osteoid osteomaya yoneltti. Nidus olarak tahmin edilen bolgenin kuretaji yapildiktan sonra otogreft ile greftleme yapildi. Eksizyonel biyopsi sonrasinda yapilan patolojik degerlendirme sonucu osteoid osteoma olarak tani kesinlestirildi. Biz bu olgu sunumuzda, metakarpal bolgede intrakortikal bir lezyon varliginda osteoid osteomanin akla getirilmesi gerektigine dikkat cekmek istedik.

[1]  J. Puget,et al.  Osteoid osteoma of the carpal bones. Two case reports. , 2006, Joint, bone, spine : revue du rhumatisme.

[2]  S. Donaldson,et al.  Osteoblastoma/Osteoid Osteoma , 2003 .

[3]  L. Wold.  Atlas Of Orthopedic Pathology , 2003 .

[4]  M. Arazi,et al.  Osteoid osteoma of the carpal bones , 2001, Archives of Orthopaedic and Trauma Surgery.

[5]  J. Dowell,et al.  Painless Osteoid Osteoma in a Metacarpal , 1999, Journal of hand surgery.

[6]  D. Resnick,et al.  Evidence of the subperiosteal origin of osteoid osteomas in tubular bones: analysis by CT and MR imaging. , 1998, AJR. American journal of roentgenology.

[7]  M. Seghatchian.  Current concepts and recent advances , 1997 .

[8]  G. Piză,et al.  Special Characteristics of Osteoid Osteoma in the Proximal Phalanx , 1997, Journal of hand surgery.

[9]  A. Weiland,et al.  Osteoid osteoma of the upper extremity. , 1993, Hand clinics.

[10]  D. Resnick,et al.  Tumors and tumor like lesions of bone imaging and pathology of specific lesions , 1988 .

[11]  B. Ghelman,et al.  Osteoid osteoma and osteoblastoma. Current concepts and recent advances. , 1986, Clinical orthopaedics and related research.

[12]  N. Green,et al.  Negative radionuclide scan in osteoid osteoma. A case report. , 1984, Clinical orthopaedics and related research.

[13]  A. Huvos.  Bone tumors, diagnosis, treatment, and prognosis , 1979 .

[14]  A. Norman.  Persistence or recurrence of pain: a sign of surgical failure is osteoid-osteoma. , 1978, Clinical orthopaedics and related research.

[15]  A. Hajjar.  [Benign tumors and tumorlike conditions]. , 1973, Majallat tibb al-asnan al-Suriyah.

[16]  R. Siegel,et al.  Combined median and ulnar nerve lesions complicating fractures of the distal radius and ulna. Two case reports. , 1968 .

[17]  H. Jaffe.  Tumors and tumorous conditions of the bones and joints , 1959 .

[18]  R. E. Carroll.  Osteoid osteoma in the hand. , 1953, The Journal of bone and joint surgery. American volume.

[19]  H. Jaffe.  OSTEOID-OSTEOMA: A BENIGN OSTEOBLASTIC TUMOR COMPOSED OF OSTEOID AND ATYPICAL BONE , 1935 .