Intra-articular osteoid osteoma (OO) of the elbow is rare. We report a 26-year-old man who presented with pain, swelling, and limited elbow range of motion. Plain computed tomography (CT) showed a radiolucent round lesion at the distal humerus and reactive bone in the olecranon fossa. Conservative treatment with salicylate failed under the suspicion of OO. During elbow arthroscopy, a red solitary lesion was noted after resection of the white reactive bone in the olecranon fossa and was excised en bloc using a bony chisel. Histological examination showed OO. The patient’s symptoms resolved the day after surgery. The patient remained asymptomatic 2 years postoperatively. This case report shows the successful clinical results of an arthroscopic procedure for intra-articular OO based on two primary goals: precise location of the lesion indicated by reactive bone on preoperative CT and histological verification using bony chisel.
By ligament reconstruction for MCL insufficiency and removing the bone fragments avoided irritation by the bone fragments, pain and instability disappeared, good range of motion was restored, and excellent outcomes were achieved in all patients. We believe that fragment excision and MCL reconstruction should be considered as the treatment option for symptomatic medial epicondyle nonunion of the humerus.
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