Arthroscopic removal of juxtaarticular osteoid osteoma of the elbow

Abstract

A case of a 42-year-old male patient with symptomatic juxtaarticular osteoid osteoma of the capitulum humeri is presented. After the clinical diagnosis was confirmed with plain radiographs, bone scan, computer tomography and magnetic resonance imaging, the patient underwent arthroscopic removal of the lesion. A partial synoviectomy was performed first and then the center of the lesion was marked with Kirschner wire using the X-ray monitoring. The marked lesion was transarticularly removed with a motorized shaver device. Post-operatively, the patient reported prompt relief of pain that had not reoccurred during 1 year of follow up. To the authors' knowledge, this is the first report of the arthroscopic removal of juxtaarticular osteoid osteoma of the humeral capitulum which promises to be an effective and less invasive alternative to the existing treatment options.

Arthroscopic excision of an intra-articular osteoid osteoma in the elbow joint

“…Zupanc et al reported arthroscopic excision of a 42-year-old male patient with symptomatic juxta-articular osteoid osteoma of the capitellum. The removal of the nidus was performed with a motorised shaver which fragmented the lesion and made it unsuitable for histopathological diagnosis 23. In our case, we did not encounter such limitation in our 23-year-old patient.…”

Osteoid Osteoma of the Distal Humerus Mimicking Sequela of Pediatric Supracondylar Fracture: Arthroscopic Resection—Case Report and A Literature Review

“…Juxta- and intra-articular osteoid osteomas are rare, especially in the elbow joint, and usually present an atypical clinical picture mimicking more common entities such as monoarticular arthritis, epicondylitis, synovial, traumatic, or degenerative joint pain [2, 6, 10–16]. The classically described symptoms for the OO are usually altered and may be misleading, especially if the tumour is intra-articular [4].…”

“…The classically described symptoms for the OO are usually altered and may be misleading, especially if the tumour is intra-articular [4]. The pain differs from the classical description in that it is described as less severe and the response to salicylates is less effective [2, 6, 10, 11, 14]. The leading symptoms usually compile joint effusion, synovitis, decreased range of motion and contractures [6, 9, 16].…”

“…Juxta- and intra-articular OOs are rare and even though they may be found in any joint, hip, elbow, and talus are the ones most reported in the literature [3–5]. They account for approximately 13% of all osteoid osteomas [6]. The occurrence of OO in uncommon locations presents a diagnostic challenge and usually there is significant time delay between symptom initiation and diagnosis due to the lack of clinical signs and radiographic features that exist in the well-established classical hallmarks of an extra-articular lesion [2–4, 7, 8].…”

“…The occurrence of OO in uncommon locations presents a diagnostic challenge and usually there is significant time delay between symptom initiation and diagnosis due to the lack of clinical signs and radiographic features that exist in the well-established classical hallmarks of an extra-articular lesion [2–4, 7, 8]. In treating intra-articular OO, no differences have been reported between using open or an arthroscopic approach [6, 9]. …”