Song Mi Hyun, Yoo Won Joon, Cho Tae-Joon, Chung Chin Youb, Park Moon Seok, Cheon Jung-Eun, Choi In Ho
Department of Orthopedic Surgery, Jeju National University Hospital, Jeju, South Korea.
Department of Orthopedic Surgery, Seoul National University Children's Hospital, 101 Daehak-ro, Jongno-gu, 110-744, Seoul, South Korea.
BMC Musculoskelet Disord. 2015 Jan 31;16(1):3. doi: 10.1186/s12891-015-0456-y.
To compare the clinical and radiological features of intra-/juxta-articular osteoid osteoma and extra-articular osteoid osteoma in skeletally immature patients, paying special attention to the skeletal complications.
Osteoid osteoma in 34 children (22 boys and 12 girls, mean age 10.4 years) was dichotomized according to the location of the nidus as intra-/juxta-articular (11 children) or extra-articular (23 children). The following features were compared: diagnostic delay, typical symptoms, synovitis and limited range of joint motion, response to treatment, typical radiographic findings, and skeletal complications.
Eight of the 11 children with intra-/juxta-articular osteoid osteoma presented with synovitis in the involved joint, which led to a delayed diagnosis for a median 9.5 months. Pain disappeared in all children with surgical or medical interventions, but at the mean 4.9-year follow-up evaluation, skeletal abnormalities around the joint were noted in 5 children (4 proximal femur and 1 distal humerus) with intra-/juxta-articular osteoid osteoma, 2 of whom required subsequent surgeries for limited hip motion caused by femoroacetabular impingement and limited range of elbow motion, respectively. In contrast, typical clinical and radiological features were observed more often in extra-articular osteoid osteoma, and only 1 child showed overgrowth of the tibia, which did not have clinical significance.
Intra-/juxta-articular osteoid osteomas in growing children exhibit different clinical and radiological features from extra-articular lesions. Skeletal abnormalities mainly develop in intra-/juxta-articular osteoid osteoma, and these may lead to permanent skeletal sequelae.
比较骨骼未成熟患者关节内/关节周围骨样骨瘤与关节外骨样骨瘤的临床和影像学特征，特别关注骨骼并发症。
将34例儿童骨样骨瘤患者（22例男孩和12例女孩，平均年龄10.4岁）根据瘤巢位置分为关节内/关节周围组（11例儿童）和关节外组（23例儿童）。比较以下特征：诊断延迟、典型症状、滑膜炎和关节活动范围受限、治疗反应、典型影像学表现以及骨骼并发症。
11例关节内/关节周围骨样骨瘤患儿中有8例出现受累关节滑膜炎，导致诊断延迟，中位延迟时间为9.5个月。所有接受手术或药物干预的患儿疼痛均消失，但在平均4.9年的随访评估中，5例关节内/关节周围骨样骨瘤患儿（4例股骨近端和1例肱骨远端）出现关节周围骨骼异常，其中2例分别因股骨髋臼撞击导致髋关节活动受限和肘关节活动范围受限而需要后续手术。相比之下，关节外骨样骨瘤更常出现典型的临床和影像学特征，只有1例患儿出现胫骨过度生长，但无临床意义。
生长中的儿童关节内/关节周围骨样骨瘤与关节外病变表现出不同的临床和影像学特征。骨骼异常主要发生在关节内/关节周围骨样骨瘤，可能导致永久性骨骼后遗症。
