Osteoid osteoma (OO) of the coracoid: a case report of arthroscopic excision and review of literature

Abstract

Osteoid osteoma (OO) of the coracoid is a rare entity that may present with variable symptoms from shoulder leading to delay in diagnosis and treatment. We present the clinical and radiological findings and management of one such case along with a review of similar cases reported in the literature. There was a delay of 2 years in diagnosis, which was later confirmed by computed tomography in addition to magnetic resonance imaging (MRI). The lesion was accessed arthroscopically and excised by unroofing and curettage. “OO” should be included in the differential diagnosis of shoulder pain in young patients not responding to long-term conservative treatment. Arthroscopic excision and curettage provide a good choice for management, with low morbidity and rapid recovery.

Arthroscopic excision of intra-articular sub-periosteal osteoid osteoma of elbow: a case report

“…They have been mostly treated with open excision of the lesion. There are only limited reports on arthroscopic removal of osteoid osteoma of elbow [ 10 – 14 ] and shoulder [ 23 , 24 ]. This case presents a unique case of arthroscopic removal of a sub-periosteal osteoid osteoma involving coronoid fossa and presentation mimicking mono-articular inflammatory arthritis Figure 1 .…”

Osteoid Osteoma in an Adult Wheelchair Basketball Player Mimicking Musculoskeletal Shoulder Pain: Red Flag or a Red Herring?

“…Our case report highlights that OO may clinically mimic, otherwise being concurrent to a common musculoskeletal condition such as SP [19,55]. Data gained from medical history, clinical examination, and diagnostic imaging are fundamental for appropriate HP management, which needs a careful triage and early diagnosis to decide if the patient is suitable for rehabilitation or surgery.…”

Osteoid osteoma of the base of the coracoid process – A case report

“…9 cases of osteoid osteomas of the coracoid process of the scapula have been reported in English literature, all of which have been initially misdiagnosed due to its resemblance to shoulder-related pathologies. Although these reported cases involved the typical age group (12–46), typical pain that is made worse at night, and typical partial pain relief by NSAIDs, diagnosis was still delayed (by 3 months-4 years) due to the presence of other factors such as pain radiation [5,9,11] and restricted range of movement [7,10,12]. These factors led to the initial diagnoses to be either: impingement syndrome [8,9,12], arthritis [10], or cervical spine discopathy.…”

“…[9] Therefore, management was based accordingly with attempts at analgesia [6,8,9,[11], [12], [13]], physiotherapy [9,12], intra-articular steroid injections [12], and arthroscopic exploration [5,8] without resolution of symptoms. In all cases, the initial X-ray did not reveal any abnormalities, therefore subsequent CT [[6], [7], [8], [9], [10],12,13], MRI [5,[8], [9], [10], [11], [12]], bone scan [7,8], or Technetium-99 m [10,13] were done which ultimately revealed a clear nidus confirming the diagnosis of “OO”. Most cases underwent definitive treatment via an open surgical method [6,7,[9], [10], [11],13] whilst a minority was done via an arthroscopic approach [5,8,12].…”

“…In all cases, the initial X-ray did not reveal any abnormalities, therefore subsequent CT [[6], [7], [8], [9], [10],12,13], MRI [5,[8], [9], [10], [11], [12]], bone scan [7,8], or Technetium-99 m [10,13] were done which ultimately revealed a clear nidus confirming the diagnosis of “OO”. Most cases underwent definitive treatment via an open surgical method [6,7,[9], [10], [11],13] whilst a minority was done via an arthroscopic approach [5,8,12].…”