Print version ISSN 0100-3984
COTTA, Ana Cristina et al. Diagnostic difficulties in osteoid osteoma of the elbow: clinical, radiological and histopathological study. Radiol Bras [online]. 2012, vol.45, n.1, pp. 13-19. ISSN 0100-3984. http://dx.doi.org/10.1590/S0100-39842012000100005.
OBJECTIVE: To describe the clinical and imaging findings that may aid in correctly diagnosing osteoid osteoma of the elbow. MATERIALS AND METHODS: The authors have retrospectively evaluated seven patients diagnosed with osteoid osteoma of the elbow histologically confirmed by bone biopsy. The patients' medical records and imaging studies were reviewed. RESULTS: Among the 142 patients with osteoid osteoma identified in the archives of the institutions, 4.9% had the lesion in the elbow, predominantly in men (2.5:1), with a mean age of 25 years. Pain and limitation of movement were the most common symptoms. Five of the patients (71.4%) had previously received a different clinical diagnosis. The mean duration of symptoms was 21 months. Radiography did not demonstrate the nidus in 42.8% of cases. Computed tomography and magnetic resonance imaging clearly demonstrated the nidus. Joint effusion was a constant finding. The histological findings corresponded to the ones usually observed in such cases. Surgical resection has brought relief of symptoms and/or functional improvement in all of the cases. CONCLUSION: It is important to consider the possibility of osteoid osteoma in young adult patients with pain, limitation of movement and signs of synovitis in the elbow refractory to conservative treatment. The detection of bone sclerosis, cortical thickening and/or periosteal reaction at radiography allows directing computed tomography towards the accurate identification of the nidus.
Keywords : Osteoid osteoma; Intra-articular; Elbow; Synovitis; Imaging; Biopsy.