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

Abstract

Osteoid osteoma (OO) is a small and painful benign osteoblastic tumour located preferentially in the shaft of long bones near the metaphyseal junctions, with a predilection for the lower limbs. Juxta- and intra-articular OOs are rare and even though hip, elbow, and talus are the most commonly reported locations, they may be found in any joint accounting for approximately 13% of all osteoid osteomas. There is usually a significant time delay between symptom initiation and diagnosis when the lesion is present in an uncommon location due to the diagnostic challenge it presents due to the lack of classical clinical signs and/or radiographic features found in the extra-articular lesions. A case of a distal humerus OO of a 15-year-old girl is presented to point out that a confounding factor, such as a previous paediatric supracondylar fracture, may further delay the already difficult diagnosis of a juxta- or intra-articular osteoid osteoma and also to emphasize the possibility of arthroscopic treatment of such lesions.

New Biological Data on a Gravettian Humerus from the Cussac Cave (Dordogne, France)

“…Among the possible causes, an osteoid osteoma seems the most likely considering the very regular margin of this depression. Juxta-and intra-articular osteoid osteomas are rare, but can occur in the olecranon fossa, the nidus located subchondrally creating a crater-like imprint at the bottom of the fossa [42]. A less convincing cause may be a posteromedial olecranon impingement, which is a common injury encountered in the throwing elbow, and is commonly associated with osteoarthritic changes including the possible presence of loose bodies and chronic stress fracture at the olecranon process [43,44].…”

Arthroscopic Excision of Delayed Diagnosed Intra-articular Osteoid Osteoma of the Elbow: A Case Report

“…Delayed diagnosis of osteoid osteoma in the elbow may lead to serious disturbances of growth during the younger years, leading to permanent impairment of articular function. Confounding factors, such as a previous pediatric supracondylar fracture and history of trauma, may make the diagnosis more difficult [ 5 ], resulting in a delayed diagnosis or even misdiagnosis of the disease. The occurrence of symptoms soon after the trauma may lead to a reduced suspicion of osteoid osteoma, as seen in the current case.…”

“…The elbow being a very rare location for intra-articular osteoid osteoma, diagnosis is challenging [ 2 - 4 ]. A confounding factor, such as a previous pediatric supracondylar fracture, may make the diagnosis even more difficult [ 5 ], resulting in misdiagnosis of the disease. In this study, the authors present a patient who had suffered from pain and limited motion as a consequence of delayed diagnosis of intra-articular osteoid osteoma in the elbow, which was then successfully treated by arthroscopic excision.…”

Bone tumours around the elbow: a rare entity

“…15,19 Nowadays, complete excision of juxta-articular osteoid osteoma of the elbow may also be performed arthroscopically. 20 Recently, Kamrani et al treated osteoid osteoma of the elbow through arthroscopic ablation in 10 patients. 21 Arthroscopic excision of the lesion was performed at a mean of 23 months (range, 12–36 months) after initial symptoms.…”