Bednar M S, Weiland A J, Light T R
Department of Orthopaedic Surgery, Loyola University of Chicago Stritch School of Medicine, Maywood, Illinois, USA.
Hand Clin. 1995 May;11(2):211-21.
Osteoid osteomas, relatively rare lesions in the upper extremity, can be a persistent source of hand or wrist pain. Patients under age 40 who have otherwise unexplained pain should be evaluated. Relief of pain with oral nonsteroidal anti-inflammatory drugs should suggest the possibility of osteoid osteoma. Examination may demonstrate localized swelling or joint effusion. Radiographs should be examined for sclerosis in the region of pain. If radiographs are nondiagnostic, a bone scan should be obtained. If the nidus cannot be clearly visualized by radiography and bone scan, a CT scan should be obtained. If the location of the nidus makes excision difficult without removal of a large block of bone, localization with a CT-guided needle or by radioisotope labeling will help to assure removal of the nidus.
骨样骨瘤在上肢相对少见，可成为手部或腕部疼痛的持续来源。应对40岁以下有不明原因疼痛的患者进行评估。口服非甾体抗炎药后疼痛缓解提示骨样骨瘤的可能性。体格检查可能显示局部肿胀或关节积液。应检查X线片，观察疼痛区域是否有硬化。如果X线片不能确诊，应进行骨扫描。如果通过X线片和骨扫描不能清晰显示瘤巢，应进行CT扫描。如果瘤巢位置导致不切除大块骨质就难以切除，通过CT引导下穿刺或放射性核素标记进行定位将有助于确保切除瘤巢。
