Bellemans Michel, de Saint-Aubin de Somerhausen Nicolas, Lê Phu Quoc
Hôpital Universitaire des Enfants Reine Fabiola, Brussels, Belgium.
Institut Universitaire Jules Bordet, Brussels, Belgium.
Case Rep Orthop. 2021 Jul 27;2021:8876584. doi: 10.1155/2021/8876584. eCollection 2021.
Osteoid osteoma is an uncommon, small, benign, self-limiting, and usually painful tumor of the skeleton. Diagnosis can be straightforward if seen in the usual locations as the femur and the tibia in young adults, who present with nocturnal pain, alleviated by salicylates. The diagnosis can be more challenging in the spine, pelvis, hand, or feet. . We report the case of an 11-year-old boy who was treated symptomatically for a painful toe since 10 months, without a definitive diagnosis. X-ray, MRI, and scintigraphy, along with the typical nocturnal pain and swelling of the toe, suggested an osteoid osteoma, confirmed by histology after excisional biopsy of the lesion.
Osteoid osteoma should always be included in the differential diagnosis when it comes to nocturnal pain without systemic signs, even in unusual places in children. The awareness should lead to a prompt diagnosis and treatment.
骨样骨瘤是一种罕见的、小型的、良性的、自限性的、通常会引起疼痛的骨骼肿瘤。如果在年轻成年人的股骨和胫骨等常见部位发现,且伴有夜间疼痛,服用水杨酸盐后疼痛缓解,诊断相对简单。但在脊柱、骨盆、手部或足部,诊断可能更具挑战性。我们报告一例11岁男孩的病例,该男孩自10个月前开始因脚趾疼痛接受对症治疗,但未明确诊断。X线、磁共振成像(MRI)和骨闪烁显像,以及典型的夜间脚趾疼痛和肿胀,提示为骨样骨瘤,病变切除活检后的组织学检查证实了这一诊断。
当出现无全身症状的夜间疼痛时,即使在儿童的不常见部位,鉴别诊断中也应始终考虑骨样骨瘤。这种认识有助于及时诊断和治疗。