Katz D, Thomazeau H
Clinique du Ter, Ploemeur, France.
J Shoulder Elbow Surg. 1997 Nov-Dec;6(6):559-63. doi: 10.1016/s1058-2746(97)90090-2.
Osteoid osteoma (OO) is a common bone disease, making up 2.6% of all bone tumors and 11% of all benign bone tumors. The typical clinical features include variable pain, often worse at night and markedly responsive to salicylates, and a characteristic roentgenographic appearance of bony sclerosis around a lucent nidus. Although this might suggest an easy diagnosis, diagnosis can often be delayed 1 or 2 years, especially when the lesion is located near a joint. Such a lesion at the upper end of the humerus is rare. In a series of 245 cases Dahlin found only 5 cases out of 18 involving the humerus. Rockwood, in a series grouping OO and osteoblastoma together, identified a 10% to 15% frequency out of all shoulder tumors. The misleading aspects of juxtaarticular OO are well known. However, involvement of the superior humeral epiphysis has only been reported briefly in one patient. The two cases presented in this article show the diagnostic difficulty encountered in this location and misleading clinical, radiologic, and sometimes histologic aspects of patient evaluation.
骨样骨瘤（OO）是一种常见的骨病，占所有骨肿瘤的2.6%，占所有良性骨肿瘤的11%。典型的临床特征包括程度不一的疼痛，常在夜间加重，对水杨酸盐有明显反应，以及在透亮瘤巢周围有特征性的骨硬化X线表现。尽管这可能提示诊断容易，但诊断往往会延迟1至2年，尤其是当病变位于关节附近时。肱骨上端出现这样的病变很罕见。在达林的245例病例系列中，18例累及肱骨的病例中仅发现5例。罗克伍德在一个将骨样骨瘤和成骨细胞瘤归为一组的病例系列中，发现在所有肩部肿瘤中其发生率为10%至15%。关节旁骨样骨瘤的误导性方面是众所周知的。然而，仅在一名患者中简要报道过肱骨上端骨骺受累的情况。本文介绍的两例病例显示了在这个部位遇到的诊断困难以及患者评估中具有误导性的临床、放射学，有时还有组织学方面的情况。
