A young boy of 20 years age complains of pain in leg at a particular site, worst at night and relieved by salicylates, the most likely diagnosis is
Correct Answer: Osteoid osteoma
Description: Ans. c (Osteoid osteoma). (Ref. Maheshwari, Orthopaedics, 3rd ed., 214; Refer to above Q.)OSTEIOD OSTEOMA# The most common benign osteoid-forming tumor is the osteoid osteoma, accounting for 10% of all benign bone umors.# It is more common in males than in females, with a peak incidence in the second decade of life.# The proximal femur is the most common site.# Dull aching pain is the most frequent symptom.# Symptoms are relieved with (NSAIDs) secondary to a high concentration of prostaglandins in the nidus.# Osteoid osteoma may have a unique pathogenic nerve supply as well, a unique finding among bone tumors.# The characteristic radiographic feature of the osteoid osteoma is the central lytic nidus that measures up to 1 cm in diameter. In the common cortical lesion, an extensive reactive sclerosis is evident, creating a fusiform bulge on the bone surface.# Technetium-MDP bone scans are invariably positive (Double density sign).# A CT scan is helpful to better anatomically locate the lesion in preoperative planning.# Nidus in osteoid osteoma is diagnostic (well seen on CT).# In the spine, the typical location for an osteoid osteoma is in the posterior elements, such as the lamina or pedicle. The lumbar spine is most commonly involved.# Rx:- Intralesional resection via the so-called burr-down technique is generally preferred over en bloc resection.- CT-guided radiofrequencv ablation (RFA) is reported as an effective, less invasive method of treating osteoid osteoma.* This method employs probes with high-frequency alternating current to induce ionic agitation and frictional heat to cause tumor necrosis.RFA is used extensively as a less invasive treatment modality with similar success rate as surgical excision.
Category:
Orthopaedics
Get More
Subject Mock Tests
Practice with over 200,000 questions from various medical subjects and improve your knowledge.
Attempt a mock test nowMock Exam
Take an exam with 100 random questions selected from all subjects to test your knowledge.
Coming SoonGet More
Subject Mock Tests
Try practicing mock tests with over 200,000 questions from various medical subjects.
Attempt a mock test now