An unrecognized osteoid osteoma of the proximal femur
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A 59-year-old patient presented with progressive right hip pain. He did not have any history of a specific illness or previous trauma. the initial evaluation by an orthopedic surgeon, the patient's pain was partially alleviated by nonsteroidal anti-inflammatory drugs. Orthopedic surgeon found transient bone marrow edema (BME) in an externally performed magnetic resonance imaging. The infection parameters were within the normal ranges. Most evidences suggested transient BME or femoral head necrosis as possible diagnoses.

CT scan including 3D reconstruction was performed defining the osteoid osteoma (OO) nidus measuring 5 mm in a subcortical location with minimal surrounding sclerotic bone. This lesion was successfully treated with percutaneous CT-guided radiofrequency ablation. Under CT guidance, an electric-driven bone biopsy needle (Oncontrol, Teleflex) was advanced through the reactive bone into the nidus of the OO. A sample was taken. The course after treatment was uneventful. A control MRI was performed 3 months after intervention. The patient had significant pain relief immediately after intervention and has remained without symptoms in a 1 year’s follow-up.

The particular case emphasizes the value of computed tomography scans diagnosing an osteoid osteoma.

Source: https://www.sciencedirect.com/science/article/pii/S1930043320300522
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