Ikegami Masachika, Matsumoto Takumi, Chang Song Ho, Kobayashi Hiroshi, Shinoda Yusuke, Tanaka Sakae
Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
Case Rep Orthop. 2017;2017:2171627. doi: 10.1155/2017/2171627. Epub 2017 Mar 28.
Osteoid osteoma in periarticular lesions tends to have an unusual presentation that likely leads to a delayed or missed diagnosis compared with a typical osteoid osteoma in the metaphysis or diaphysis of the long bone. In cases that are unresponsive to conservative treatment, surgical interventions including en bloc resection, computed tomography-guided percutaneous treatment, and arthroscopic resection have been performed; however, these methods frequently result in inadequate tumor resection and recurrence. Here we present a case of a 16-year-old girl with osteoid osteoma in the talar neck presenting as anterior impingement syndrome due to marked synovitis in the ankle joint which was successfully treated without complications by arthroscopic synovectomy and tumor resection followed by intraoperative 3D C-arm-based imaging confirming complete tumor lesion removal. Her pain was relieved immediately after the surgery, and there was no recurrence at 12 months of follow-up. This is the first case report of the surgical treatment of the osteoid osteoma in the talar neck with the combination methods of arthroscopy and 3D C-arm-based imaging.
与长骨干骺端或骨干的典型骨样骨瘤相比，关节周围病变中的骨样骨瘤往往表现不寻常，这可能导致诊断延迟或漏诊。对于保守治疗无反应的病例，已实施了包括整块切除、计算机断层扫描引导下经皮治疗和关节镜切除在内的手术干预；然而，这些方法常常导致肿瘤切除不彻底和复发。在此，我们报告一例16岁女孩，其距骨颈骨样骨瘤表现为踝关节明显滑膜炎所致的前撞击综合征，通过关节镜下滑膜切除术和肿瘤切除术成功治疗，术中基于3D C型臂成像确认肿瘤病变完全切除，无并发症发生。术后她的疼痛立即缓解，随访12个月无复发。这是首例采用关节镜和基于3D C型臂成像的联合方法治疗距骨颈骨样骨瘤的病例报告。
