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冠状窝骨膜下骨样骨瘤酷似早期肘关节病:一例报告

Subperiosteal Osteoid Osteoma in the Coronoid Fossa Mimicking Early Elbow Arthropathy: A Case Report.

作者信息

Dharmshaktu Ganesh Singh, Agarwal Naveen, Dharmshaktu Ishwar Singh, Agarwal Anant, Pangtey Tanuja

机构信息

Department of Orthopaedics, Government Medical College, Haldwani, Uttarakhand, India.

Department of Pathology, Government Medical College, Haldwani, Uttarakhand, India.

出版信息

J Orthop Case Rep. 2023 Aug;13(8):121-126. doi: 10.13107/jocr.2023.v13.i08.3842.

Abstract

INTRODUCTION

The elbow pain and restricted movement is a nagging problem and elbow arthropathies need to be excluded. On rare instances, uncommon etiology like a benign lesion is the culprit and the diagnosis would require judicious clinicoradiological correlation. Osteoid osteoma in the intra- or juxta-articular region is reported in the literature as rare, sporadic report.

CASE REPORT

A 23-year-old, Indian male patient presented with a provisional diagnosis of early elbow arthropathy on account of unexplained pain and restricted elbow movement without a history of trauma. He was subjected to appropriate investigations revealing synovial hypertrophy, effusion, and bone edema suggestive of early arthropathy. Additional imaging led to an uncommon definitive diagnosis. An intra-articular osteoid osteoma was found over the medial aspect of the coronoid fossa with a thin rim of cortical rim projecting anteriorly. The lesion was diagnosed and delineated on computerized tomography and an open excision of the lesion and synovectomy was done for histopathological evaluation. Histology confirmed the presence of an osteoid osteoma at an uncommon location.

CONCLUSION

The careful appreciation of radiological images is critical to not miss significant etiology that may mimic non-specific elbow pain. High index of suspicion coupled with appropriate diagnostic imaging results in early diagnosis and appropriate management. Osteoid osteoma should be a differential diagnosis in cases with pain and restricted elbow movement and excision of which results in recovery of painless range of motion.

摘要

引言

肘部疼痛和活动受限是一个棘手的问题,需要排除肘部关节病。在极少数情况下,罕见的病因如良性病变是罪魁祸首,诊断需要审慎的临床与影像学关联。文献报道关节内或关节周围区域的骨样骨瘤罕见,多为散发病例报告。

病例报告

一名23岁的印度男性患者因不明原因的疼痛和肘部活动受限前来就诊,初步诊断为早期肘部关节病,无外伤史。他接受了相关检查,结果显示滑膜增生、积液和骨水肿,提示早期关节病。进一步的影像学检查得出了一个罕见的确切诊断。在冠状窝内侧发现了一个关节内骨样骨瘤,有一薄层皮质边缘向前突出。通过计算机断层扫描对病变进行了诊断和定位,并对病变进行了开放切除和滑膜切除术以进行组织病理学评估。组织学证实了在一个罕见位置存在骨样骨瘤。

结论

仔细解读放射影像对于不遗漏可能模仿非特异性肘部疼痛的重要病因至关重要。高度的怀疑指数加上适当的诊断性影像学检查可实现早期诊断和恰当治疗。对于肘部疼痛和活动受限的病例,骨样骨瘤应作为鉴别诊断之一,切除后可恢复无痛活动范围。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2c7/10465741/b5ea06a8b5a8/JOCR-13-121-g001.jpg

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