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      Intra‐articular osteoid osteoma of the capitulum: A diagnostic challenge

      case-report

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          Abstract

          Here, we describe the first case of intra‐articular osteoid osteoma of the capitulum, which is presented as elbow pain, extension lack, and sensation of click in joint flexion. Surgical treatment either arthroscopic or open is more in use in this location of the tumor than cortical osteoid osteoma.

          Abstract

          We describe the first case of intra‐articular osteoid osteoma of the capitulum presented as elbow pain, extension lack, and sensation of click in joint flexion. Surgical treatment either arthroscopic or open is more in use in tumor location than cortical osteoid osteoma. Radiofrequency ablation should be used with extreme caution.

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          Most cited references21

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          Intraarticular osteoid osteoma: clinical features, imaging results, and comparison with extraarticular localization.

          Katalin Köllo, József Lakatos, Miklos Szendrõi … (2004)
          Intraarticular osteoid osteoma is uncommon and presents diagnostic difficulties, which are important for both rheumatologists and orthopedic surgeons. Clinical symptoms, imaging procedures, differential diagnostic problems, and treatment results of intraarticular as compared with extraarticular osteoma are analyzed in this retrospective study. Nineteen patients with intraarticular osteoid osteomas (Group A), with a mean followup period of 34 months, are compared with 15 others with extraarticular lesions (Group B). Nine intraarticular tumors were located in the hip, 3 in the elbow, 6 in the ankle, and one in the first metatarsal head. The nonspecific symptoms in Group A, such as chronic synovitis, decreased range of motion, joint effusion, contractures, and lack of the intense perifocal sclerotic margin on radiographs, led to significant delay in diagnosis (on average 26.6 mo in Group A, 8.5 mo in Group B). The extreme variety of previous diagnoses at referral reflect the problems of differential diagnosis. A detectable nidus is often absent on conventional radiograph. Bone scintigraphy is unspecific and often fails to visualize the nidus. Computed tomography scans were accurate in two-thirds of the intraarticular and in 90% of extraarticular cases. Magnetic resonance image findings, although sometimes controversial, provided essential additional information for the correct diagnosis and therapy. Clinical symptoms and imaging signs of intraarticular osteoid osteomas were significantly different from the classical hallmarks of extraarticular lesions. The 10% intraarticular occurrence of osteoid osteomas in this series is not as rare as some investigators suggest. The radiological and clinical findings are uncharacteristic and misleading, and the lesions are difficult to identify. Careful search for history data, such as nocturnal pain and positive salicylate test, in addition to extensive imaging procedures, led to the correct diagnosis prior to surgery in two-thirds of our patients with intraarticular osteoid osteomas.
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            Osteoid-osteoma: a benign osteoblastic tumour composed of osteoid and atypical bone

            HL Jaffe, HL Jaffe, H. JAFFE … (1935)
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              Short- to long-term follow-up of total femoral replacement in non-oncologic patients

              Andreas Toepfer, Norbert Harrasser, Isabel Petzschner … (2016)
              Background Compromised bone stock and heavily impaired structural integrity after multiple endoprosthetic revision surgeries can lead to a comparable condition as encountered in musculoskeletal tumor surgery. Total femoral replacement (TFR) can restore femoral integrity and allow patients to resume ambulation. Even though several authors reported their results of TFR, so far many questions are still on debate: Which patients are at risk to experience low functional outcome? Do complications and clinical outcome after TFR depend on the indication for the surgery (e.g. periprosthetic fractures or aseptic loosening) or the age of the patients? The purpose of the present study was to compare complication rates after TFR performed with modular total femur prosthesis MML (Fa. ESKA/Orthodynamics) in patients without malignant disease. Methods We conducted a retrospective chart review and functional investigation of patients treated with a TFR for non-oncologic conditions from 1995 to 2015 and a minimum follow-up of 2 years. Complications were recorded according to the Henderson-Classification; outcome was evaluated with established clinical scores. The indication for TFR was periprosthetic fracture (Group A, n = 11) or aseptic loosening (Group B, n = 7) with massive bone defect of the femur deemed unsuitable for conventional arthroplastic or biologic reconstruction. Results Eighteen patients matched the inclusion criteria and could be investigated clinically after a mean follow-up of 80 months (range: 28–132). Before TFA, all patients had previously undergone multiple operations (range: 1–8). The overall failure rate for any reason was 72% (n = 13/18), leading to a total of 37 surgical revisions with total exchange of TFR in 22% (n = 4/18). Most common failure mechanism was Type I (soft tissue), followed by Type IV (infection) and Type III (mechanical failure). According to Enneking’s functional evaluation method (MSTS-Score), the function ranged from 1 to 15 with a mean of 10 ± 4 out of 30. Conclusion TFR is a salvage procedure to restore mechanical integrity and regain functional ability after extensive femoral bone loss. Outcome of the patients in the present study did mainly depend on the age at reconstruction and not on the indication for TFR.
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                Author and article information

                Contributors
                Mehrdad Bahrabadi:
                ORCID: https://orcid.org/0000-0002-8798-0253
                mehrdad.bahrabadi@gmail.com , mbahrabadi.rcrdc@gmail.com
                Journal
                Journal ID (nlm-ta): Clin Case Rep
                Journal ID (iso-abbrev): Clin Case Rep
                Journal ID (doi): 10.1002/(ISSN)2050-0904
                Journal ID (publisher-id): CCR3
                Title: Clinical Case Reports
                Publisher: John Wiley and Sons Inc. (Hoboken )
                ISSN (Electronic): 2050-0904
                Publication date (Electronic): 20 May 2022
                Publication date Collection: May 2022
                Volume: 10
                Issue: 5 ( doiID: 10.1002/ccr3.v10.5 )
                Electronic Location Identifier: e05796
                Affiliations
                [ 1 ] ringgold 440827; Department of Orthopaedic Surgery Shafa Yahyaian Hospital, Iran University of Medical Sciences Tehran Iran
                [ 2 ] ringgold 440827; Department of Orthopaedic Surgery Rasool Akram Medical Complex Iran University of Medical Sciences Tehran Iran
                [ 3 ] ringgold 440827; Student Research Committee Faculty of Medicine Iran University of Medical Science Tehran Iran
                [ 4 ] Urology Research Center Tehran University of Medical Sciences Tehran Iran
                [ 5 ] The University of Texas Health Science Center Houston Texas USA
                [ 6 ] Ferdowsi University of Mashhad Mashhad Iran
                Author notes
                [*] [* ] Correspondence

                Mehrdad Bahrabadi, Department of Orthopaedic Surgery, Rasool Akram Medical Complex, Iran University of Medical Sciences, Tehran, Iran.

                Email: mehrdad.bahrabadi@ 123456gmail.com

                Author information
                https://orcid.org/0000-0002-8798-0253
                https://orcid.org/0000-0002-1941-7370
                Article
                Publisher ID: CCR35796
                DOI: 10.1002/ccr3.5796
                PMC ID: 9122796
                PubMed ID: 35600026
                SO-VID: eba59afb-d4f4-47df-8de3-12297402ef6b
                Copyright © © 2022 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.
                License:

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                Date received : 08 January 2022
                Date accepted : 18 April 2022
                Page count
                Figures: 5, Tables: 0, Pages: 5, Words: 2316
                Categories
                Subject: Case Report
                Subject: Case Reports
                Custom metadata
                source-schema-version-number 2.0
                cover-date May 2022
                details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_JATSPMC version:6.1.6 mode:remove_FC converted:20.05.2022

                Keywords: capitulum,intra‐articular,osteoid osteoma
                Data availability:
                Keywords: capitulum, intra‐articular, osteoid osteoma

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