Kaweblum M, Lehman W B, Bash J, Grant A D, Strongwater A
Pediatric Orthopaedic Department, Hospital for Joint Diseases Orthopaedic Institute, New York, New York.
Orthop Rev. 1993 Dec;22(12):1305-13.
Fifty-two cases of osteoid osteoma in children under 5 years of age were collected from the English literature and reviewed, along with seven cases from the Hospital for Joint Diseases. Analytic emphasis was placed on the clinical and radiologic difficulties encountered in the diagnosis of osteoid osteoma in children. Diagnosis is especially challenging in patients that are just beginning to walk. Osteoid osteoma is often confused with many other entities. Although pain was the most frequent clinical manifestation, it was absent in 12% of cases; limp tenderness, swelling, and atrophy were the next most frequent findings. When standard radiographic findings proved negative for this condition, technetium bone scans were of considerable efficacy in identifying the tumor. When used, computerized tomograms permitted visualization and precise localization of the tumors in all cases. Bone deformities and leg-length discrepancies were found in more than 25% of the cases. Mini-block excision is recommended at diagnosis.
从英文文献中收集并回顾了52例5岁以下儿童骨样骨瘤病例，同时纳入了关节疾病医院的7例病例。分析重点在于儿童骨样骨瘤诊断中遇到的临床和放射学难题。对于刚开始学步的患儿，诊断尤其具有挑战性。骨样骨瘤常与许多其他病症相混淆。尽管疼痛是最常见的临床表现，但12%的病例并无疼痛；跛行、压痛、肿胀和萎缩是其次常见的表现。当标准影像学检查结果为阴性时，锝骨扫描在识别肿瘤方面具有相当的功效。使用计算机断层扫描时，在所有病例中都能实现肿瘤的可视化和精确定位。超过25%的病例存在骨畸形和腿长差异。建议在诊断时进行微型块状切除。
