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拇趾骨样骨瘤的异常延迟表现:一例报告。

Unusually delayed manifestation of a hallux osteoid osteoma: A case report.

作者信息

Özdemir Meltem, Kavak Rasime Pelin, Demirler Şimşir Begüm, Duman Evrim

机构信息

University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Department of Radiology, Ankara, Turkey.

University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Department of Orthopaedic Surgery, Ankara, Turkey.

出版信息

Int J Surg Case Rep. 2020;68:8-11. doi: 10.1016/j.ijscr.2020.02.032. Epub 2020 Feb 19.

Abstract

INTRODUCTION

Osteoid osteomas are benign osteoblastic bone tumors mostly seen in patients in the second or third decade of life, and they most frequently involve the femur and tibia. Hallux osteoid osteoma is an extremely rare occurrence with only 14 reported cases to date.

PRESENTATION OF CASE

A 46-year-old woman with a right hallux pain for the last 18 months was admitted. Her foot radiographs showed a small sclerotic focus on the distal phalanx and degenerative changes in the interphalangeal joint of the hallux. The complaints of the patient were attributed to osteoarthritis involving the interphalangeal joint and non-steroidal anti-inflammatory drugs were administered; however, the patient's condition did not improve, and hallux osteoid osteoma could not be correctly diagnosed until a CT scan was performed.

DISCUSSION

We present a case of hallux osteoid osteoma in which the diagnosis was delayed greatly due to the unusuality of the lesion location, the advanced age of the patient, and the uncertainty of the clinical and radiographic appearance.

CONCLUSION

Although rare, osteoid osteoma may occur in the hallux. Even if the patient age, pain pattern, and radiographic findings do not exactly meet the classical definitions for osteoid osteoma, this tumor should always be included in the differential diagnosis list in patients presenting with foot pain.

摘要

引言

骨样骨瘤是一种良性成骨性骨肿瘤,多见于第二或第三个十年的患者,最常累及股骨和胫骨。拇趾骨样骨瘤极为罕见,迄今为止仅有14例报告病例。

病例介绍

一名46岁女性因右拇趾疼痛18个月入院。她的足部X线片显示远端趾骨有一个小的硬化灶,拇趾指间关节有退行性改变。患者的症状被归因于累及指间关节的骨关节炎,并给予了非甾体抗炎药;然而,患者的病情并未改善,直到进行CT扫描才正确诊断出拇趾骨样骨瘤。

讨论

我们报告一例拇趾骨样骨瘤病例,由于病变位置不寻常、患者年龄较大以及临床和影像学表现的不确定性,诊断被大大延迟。

结论

尽管罕见,但骨样骨瘤可能发生在拇趾。即使患者年龄、疼痛模式和影像学表现不完全符合骨样骨瘤的经典定义,在出现足部疼痛的患者中,这种肿瘤也应始终列入鉴别诊断清单。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58d4/7044663/f887f9527a3c/gr1.jpg

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本文引用的文献

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Foot and Ankle Osteoid Osteomas.足踝骨样骨瘤
J Foot Ankle Surg. 2018 Jul-Aug;57(4):826-832. doi: 10.1053/j.jfas.2017.11.019. Epub 2018 Mar 2.
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Hallux Osteoid Osteoma: A Case Report and Literature Review.拇趾骨样骨瘤:一例报告及文献综述。
Open Orthop J. 2017 Sep 30;11:1066-1072. doi: 10.2174/1874325001711011066. eCollection 2017.
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Osteoid osteoma of the foot and ankle--A systematic review.足踝部骨样骨瘤——一项系统评价
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Imaging features of foot osteoid osteoma.足部骨样骨瘤的影像学特征。
Skeletal Radiol. 2010 Jul;39(7):683-9. doi: 10.1007/s00256-009-0737-3. Epub 2009 Jul 15.
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Medical management of osteoid osteoma.骨样骨瘤的药物治疗
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