Carcopino J M, Jagueux M, Gross P, Moinet P
Chir Pediatr. 1986;27(2):110-3.
It is about an unique case of an intra-articular osteoid osteoma, located in the back of the acetabulum in a 14 years old girl. Synovitis made clinical and radiological appearances very suggestive of an arthritis. Diagnosis was recalled in the view of biological negativity, the notion of nocturnal pains, reduced by aspirin, and especially radiological features with densification of the back of the acetabulum. Scintigraphy revealed hyperfixation located in the back of the acetabulum and scanner showed a picture, in the same place, buldging towards the joint, suggestive of the osteoid osteoma. The operation, made by anterior approach with anterior dislocation of the hip, allowed the "in bloc" resection of an osseus piece whose immediate radiographic examination confirmed that the whole osteoma was removed. A synovial biopsy was also performed. The pathologist confirmed the diagnosis and showed a reactional synovitis within the soft tissues. Pain disappeared as soon as the waking up. This case report is interesting because: this localization is very exceptional, the reactional synovitis was evocating of an arthritis, the iconography is absolutely complete, a review of publications is done for this subject.
这是一例关于关节内骨样骨瘤的独特病例,发生在一名14岁女孩髋臼后方。滑膜炎使临床和放射学表现非常类似于关节炎。鉴于生物学检查结果为阴性、夜间疼痛的症状(服用阿司匹林后减轻),特别是髋臼后方致密化的放射学特征,最终做出了诊断。骨闪烁显像显示髋臼后方有放射性浓聚,扫描显示同一部位向关节内突出的影像,提示骨样骨瘤。通过前路髋关节前脱位进行手术,整块切除了一块骨质,术后即刻的放射学检查证实整个骨瘤已被切除。同时还进行了滑膜活检。病理学家证实了诊断,并显示软组织内有反应性滑膜炎。患者术后苏醒时疼痛即消失。本病例报告很有意思,原因如下:这种定位非常罕见,反应性滑膜炎类似于关节炎,影像学检查完整,并且对该主题的相关文献进行了综述。