Osteoid Osteoma of the Terminal Phalanges

Abstract

Four cases of osteoid osteoma of the terminal phalanx--a very rare location--are presented. The clinical picture of cell cases is essentially the same, gradual swelling of the terminal phalanx with enlargement of the nail and pain, particularly at night and relievable by aspirin. The treatment was operative and of double value. 1. The osteoid osteoma is removed; 2. Cosmetic result is obtained by reduction of the size of the terminal phalanx.

Imaging features of osteoid osteoma of the phalanges

“…Only isolated case reports had described OO of the phalanges prior to the series published by Giannikas et al in 1977, which reported 4 cases of OO in the distal phalanges [12]. Since then, small series of phalangeal OO have been published [3,10,13].…”

“…Themistocleous and co-workers reported 9 phalangeal OOs in their series of 39 cases of upper limb OO, but they only described the imaging appearances of 2 of these lesions [17]. Table 3 highlights imaging findings that have been described in previously published cases of phalangeal OO [3,10,12,13,[17][18][19][20][21][22][23][24].…”

“…Whilst there have been isolated case reports and small series of phalangeal OO published in the literature, none has specifically focused on the radiographic and cross-sectional imaging features [3,10,12,13]. Given that the difficulty in diagnosis is often attributed to atypical imaging findings, our aim was to assess the imaging of this relatively rare entity to assess if there are consistent imaging features of phalangeal OO.…”

“…Giannikas et al [12] Index finger Distal Yes Thin rim No No Giannikas et al [12] Little finger Distal Yes Thin rim No No Giannikas et al [12] Ring …”

Osteoid osteoma of the upper extremity. A diagnostic challenge

“…In the phalanges and metacarpals, presentation is rare in the terminal phalanx, in the middle is exceptional, whereas the proximal phalanx [7][8][9], and metacarpals represent the most common sites [10]. Clinical findings may vary; in extra-articular localizations, the lesion presents with a well localized pain wheras in juxta-or intra-articular cases the lesion is accompanied by synovitis [11], pain is usually more diffuse and restriction of motion is common.…”