Patellar Osteoid Osteoma as a Cause of Anterior Knee Pain in Adolescents: A Case Report and Literature Review

Abstract

Anterior Knee Pain (AKP) is an important cause of complaint in adolescents which can suggest many possible diseases. Scientific literature concerning this complex symptom is wide and diversified. We report a rare case of patellar osteoid osteoma which affected a thirteen-year-old female who had suffered from anterior left knee pain for almost six months. The diagnosis was suspected from an accurate anamnesis, a careful clinical examination, and confirmed by imaging. Several minimally invasive techniques can be employed to treat osteoid osteoma. However, we consider CT-guided percutaneous drilling the safest and most effective procedure in case of patellar location. Despite its rarity, patellar osteoid osteoma ranges in the differential diagnosis for all patients suffering from AKP.

A Rare Cause of Anterior Knee Pain in a Young Athlete and a Delayed Diagnosis: Osteoid Osteoma of the Patella

“…The average delay for diagnosis of intra-articular OO has been reported by Szendroi et al at 26.6 months and by Rolvien et al at 20.7 months [5,17]. For patellar OO, except for a case in a 13-year-old girl where diagnosis came six months after the first symptoms, the delay till diagnosis ranges from 12 months (in our case) to three years [9,12].…”

“…Hip joint is the most commonly affected area, followed by the ankle, elbow, wrist, and knee [2,6]. Patella is a rare site for OO, and only a few cases have been reported in the literature [7][8][9][10][11][12][13].…”

“…Our patient presented with an ill-defined AKP that was first attributed to a mild injury during training and after that to Sinding Larsen Johansson and Hoffa's syndrome before final diagnosis. Other common misdiagnosis for patella OO across the literature includes chondromalacia patella in three cases: patellofemoral malalignment, osteochondritis dissecans, meniscal tear, and quadricept tendinitis [7][8][9]12,13]. Half of the cases underwent at least one diagnostic arthroscopy before final diagnosis [8,10,13].…”

“…For most patellar OO, open resection was the chosen treatment, while Bavaneh et al applied mosaicplasty technique after open resection for the cartilage defect [7,10,13]. On the other hand, Franceschi et al described a CT-guided arthroscopic resection of a subchondral patellar OO and Chillemi et al described a percutaneous CT-guided drilling of the nidus with good results [11,12]. Our patient was successfully treated with the method of RF ablation under CT guidance ( Figure 6) without any cartilage complications as implied by the complete resolution of the symptoms and absence of complaints during follow-up.…”

Συσχέτιση Κλινικής Εικόνας Και Απεικονιστικών Ευρημάτων Ασθενών Με Οστεοειδές Οστέωμα Πριν Και Μετά Από Θερμοκαυτηρίαση

“…ζε φιν ην άθξν θαη ζε απηήλ ηελ πεξίπησζε ε ζσζηή δηάγλσζε κπνξεί λα αξγήζεη επίζεο αξθεηά(31)(32)(33)(34). εζσηεξηθφ ηεο θσιεάο απνηειείηαη απφ έλα πινχζην ζχκπιεγκα ηλψδνπο ζπλδεηηθνχ ηζηνχ θαη αγγεηαθνχ πιέγκαηνο(23,24,(47)(48)(49)(50)(51)(52)(53)(54)(55)60). Πνιιέο θνξέο ην ζχκπιεγκα απηφ κπνξεί λα αλεπξεζεί θαη ζηελ γεηηνληθή αληηδξαζηηθή ζθιεξία.…”