Francesco Barca, Andrea Leti Acciaro, Vincenzo Spina
Hesperia Hospital, Modena, Italy.
Foot Ankle Int. 2002 Mar;23(3):264-7. doi: 10.1177/107110070202300314.
We report five cases of intra-articular osteoid osteoma. Physical findings of osteoid osteoma vary with the site of the tumor. Juxta- and intra-articular osteoid osteomas present various atypical and nonspecific features. They are recorded both for their rarity and for the unusual clinical and roentgenographic findings that may delay diagnosis or induce misdiagnosis. Specialized imaging techniques may hasten diagnosis, but only an accurate clinical history, with a high index of suspicion, can allow for a proper diagnosis. When the diagnosis is suspected, we suggest that the most sensitive test is a "three-phase" technetium-99m bone-scan followed by computerized tomographic-scanning. Detailed evaluation of the suspected area, using thin sections is required to prevent misinterpretation, especially in a diagnosis involving first sprain of an ankle. The following cases of intra-articular osteoid osteoma illustrate the problems encountered in their diagnosis.
我们报告了5例关节内骨样骨瘤。骨样骨瘤的体格检查结果因肿瘤部位而异。关节周围和关节内骨样骨瘤呈现出各种非典型和非特异性特征。记录这些病例是因其罕见性以及可能导致诊断延迟或误诊的不寻常临床和X线表现。专业的成像技术可能会加快诊断速度，但只有准确的临床病史以及高度的怀疑指数才能做出正确诊断。当怀疑有诊断时，我们建议最敏感的检查是“三相”锝-99m骨扫描，随后进行计算机断层扫描。需要使用薄层对可疑区域进行详细评估，以防止误诊，尤其是在涉及首次踝关节扭伤的诊断中。以下关节内骨样骨瘤病例说明了其诊断中遇到的问题。
