Misdiagnosis and treatment of proximal femoral osteoid osteoma

Abstract

Aims: Herein, we examined the efficacy of open resection in proximal femoral osteoid osteoma (OO) treatment. Besides, we analysed the causes of misdiagnosis of proximal femoral OO to provide a reference for its diagnosis and treatment.Methods: This was a retrospective study involving 29 patients with proximal femoral OO admitted into our hospital from January 2010 to January 2018. The baseline characteristics of the participants included; 21 males and 9 females, aged between 13 to 25 (mean 16.2) years old, and the course of the disease was 1 to 14 (mean 6.1) months. We used previous medical experience records of the patients to analyze for the causes of misdiagnosis. Moreover, we compared the difference between preoperative and postoperative treatment practices in alleviating pain in OO patients and restoring hip function. Follow-ups were conducted regularly, and patients advised to avoid strenuous exercises for 3 months.Results: We followed up 29 patients (21 intercortical, 2 sub-periosteal, and 6 medullary) for an average of 42.5 months. We found that 13 patients (44.8%) had been misdiagnosed of synovitis, Perthes disease, osteomyelitis, intra-articular infection, and joint tuberculosis, whose average time from symptoms to diagnosis were 9.8 months. Postoperative pain score and joint function score improved significantly compared with preoperative, and complications were rare.Conclusion: Open surgical resection constitutes an effective treatment for proximal femoral OO by accurately and completely removing the nidus. Lack of understanding, wrong choice of examination, and the complexity and diversity of clinical manifestations constitute the main reasons for the misdiagnosis of proximal femoral OO.

Intraarticular osteoid osteoma of the knee misdiagnosed as meniscal tear: a case report

“…Although the lesion was finally diagnosed as intraarticular osteoid osteoma, the patient underwent several rounds of treatment, including physiotherapy, platelet-rich plasma therapy, intra- Misdiagnosis of osteoid osteoma is not uncommon. Liu et al 2 retrospectively reviewed the profiles of 29 patients with an osteoid osteoma of the proximal femur with an average follow-up of 42.5 mo. According to Liu's report, 13 patients (44.8%) were initially misdiagnosed with synovitis, Perthes disease, intraarticular infection, osteomyelitis, and joint tuberculosis.…”

“…Misdiagnosis of osteoid osteoma is not uncommon. Liu et al 2. retrospectively reviewed the profiles of 29 patients with an osteoid osteoma of the proximal femur with an average follow-up of 42.5 mo.…”

“…For that reason, misdiagnosis of osteoid osteoma occurs frequently. In one study, 44.8% of patients with osteoid osteoma were misdiagnosed with other lesions such as intraarticular infection, synovitis, Perthes disease, osteomyelitis, and joint tuberculosis 2…”

“…In one study, 44.8% of patients with osteoid osteoma were misdiagnosed with other lesions such as intraarticular infection, synovitis, Perthes disease, osteomyelitis, and joint tuberculosis. 2 Intraarticular localization of osteoid osteoma accounts for about 10% of those lesions and is associated with nonspecific pain and symptoms that generally are misdiagnosed with more common joint pathologies, such as inflammatory joint diseases or osteochondritis dissecans (OCD). 3 For that reason, its diagnosis has been made with a significant delay compared to extraarticular lesions (26.6 mo vs. 8.5 mo).…”