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Robin F, Guillin R, Lecigne R, Violas P, Burtin F, Maximen J, Ropars M, Bousson V, Guggenbuhl P. The use of bisphosphonates in osteoid osteoma and osteoblastoma of difficult location: A useful and safe medical alternative. Joint Bone Spine 2025; 92:105911. [PMID: 40311917 DOI: 10.1016/j.jbspin.2025.105911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2025] [Revised: 04/16/2025] [Accepted: 04/18/2025] [Indexed: 05/03/2025]
Affiliation(s)
- François Robin
- Inserm, Univ Rennes, INRAE, CHU Rennes, U 1317, Institut NuMeCan (Nutrition Metabolisms and Cancer), Rennes, France; Rheumatology Department, Rennes University Hospital, Rennes, France.
| | - Raphael Guillin
- Radiology Department, Rennes University Hospital, Rennes, France
| | - Romain Lecigne
- Radiology Department, Rennes University Hospital, Rennes, France
| | - Philippe Violas
- Pediatric Orthopedic Surgery Department, Rennes University Hospital, Rennes, France
| | - Florence Burtin
- Anatomic pathology Department, Rennes University Hospital, Rennes, France
| | - Julien Maximen
- Inserm, Univ Rennes, INRAE, CHU Rennes, U 1317, Institut NuMeCan (Nutrition Metabolisms and Cancer), Rennes, France; Orthopedic Surgery Department, Rennes University Hospital, Rennes, France
| | - Mickael Ropars
- Inserm, Univ Rennes, INRAE, CHU Rennes, U 1317, Institut NuMeCan (Nutrition Metabolisms and Cancer), Rennes, France; Orthopedic Surgery Department, Rennes University Hospital, Rennes, France
| | - Valérie Bousson
- Radiology Department, Hôpital Lariboisière, AP-HP.Nord-Université Paris Cité, 2, rue Ambroise-Paré, 75010 Paris, France
| | - Pascal Guggenbuhl
- Inserm, Univ Rennes, INRAE, CHU Rennes, U 1317, Institut NuMeCan (Nutrition Metabolisms and Cancer), Rennes, France; Rheumatology Department, Rennes University Hospital, Rennes, France
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Degboé Y, Nezzar C, Alary P, Maëva M, Bulai Livideanu C, Laroche M. Management of Bone Health in Adult Mastocytosis. Curr Osteoporos Rep 2025; 23:10. [PMID: 39946039 PMCID: PMC11825596 DOI: 10.1007/s11914-025-00901-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/21/2025] [Indexed: 02/16/2025]
Abstract
PURPOSE OF REVIEW The present review will examine bone disease in mastocytosis, analyze the existing literature on its management, and propose a strategy for osteoporosis treatment in systemic mastocytosis. This strategy is based on both the available scientific evidence and the experience gained at our expert center (CEREMAST). RECENT FINDINGS Systemic mastocytosis is a rare disorder, primarily affecting the bone and leading to osteoporosis, bone pain, and bone structural abnormalities. While traditionally described in indolent systemic mastocytosis, bone involvement is also observed in bone marrow mastocytosis. The true prevalence of systemic mastocytosis is likely underreported, highlighting the importance for clinicians to be familiar with the condition, particularly in cases of osteoporosis. Osteoporosis management typically involves bisphosphonates, with potential benefits from combining them with specific treatments like interferon in severe osteoporosis with vertebral fractures. The potential of new mast cell-targeting molecules to treat bone involvement needs to be demonstrated. This review provides a guide for osteoporosis and bone pain management in systemic mastocytosis.
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Affiliation(s)
- Yannick Degboé
- Rheumatology Department, CHU de Toulouse and Université de Toulouse, Toulouse, France.
- Mastocytosis Expert Centre - CEREMAST Toulouse, Toulouse, France.
- INSERM U1291 INFINITY, Toulouse, France.
| | - Coralie Nezzar
- Rheumatology Department, CHU de Toulouse and Université de Toulouse, Toulouse, France
| | - Pauline Alary
- Rheumatology Department, CHU de Toulouse and Université de Toulouse, Toulouse, France
| | - Masson Maëva
- Rheumatology Department, CHU de Toulouse and Université de Toulouse, Toulouse, France
- INSERM U1291 INFINITY, Toulouse, France
| | - Cristina Bulai Livideanu
- Mastocytosis Expert Centre - CEREMAST Toulouse, Toulouse, France
- INSERM U1291 INFINITY, Toulouse, France
- Dermatology Department, CHU de Toulouse, Toulouse, France
| | - Michel Laroche
- Rheumatology Department, CHU de Toulouse and Université de Toulouse, Toulouse, France
- Mastocytosis Expert Centre - CEREMAST Toulouse, Toulouse, France
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Tebbaa El Hassali A, Barrached M, Lachkar A, Abdeljaouad N, Yacoubi H. An Atypical Presentation of an Osteoid Osteoma of the Lesser Trochanter Resected via the Ludloff Approach. Cureus 2024; 16:e67811. [PMID: 39323724 PMCID: PMC11423703 DOI: 10.7759/cureus.67811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2024] [Indexed: 09/27/2024] Open
Abstract
Osteoid osteoma is a benign bone tumor that frequently affects young adults. The clinical presentation is variable, and the course can lead to spontaneous regression or persistence, necessitating medical or surgical treatment. We report the case of a young patient with an exceptional localization of an osteoid osteoma at the lesser trochanter, exhibiting atypical clinical and radiological features. The tumor was resected via the Ludloff approach. Here, we discuss our diagnostic and therapeutic approach in light of the literature.
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Affiliation(s)
- Achraf Tebbaa El Hassali
- Orthopedics and Traumatology, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy of Oujda, Mohammed I University, Oujda, MAR
| | - Mohammed Barrached
- Orthopedics and Traumatology, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy of Oujda, Mohammed I University, Oujda, MAR
| | - Adnane Lachkar
- Orthopedics and Traumatology, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy of Oujda, Mohammed I University, Oujda, MAR
| | - Najib Abdeljaouad
- Orthopedics and Traumatology, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy of Oujda, Mohammed I University, Oujda, MAR
| | - Hicham Yacoubi
- Orthopedics and Traumatology, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy of Oujda, Mohammed I University, Oujda, MAR
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Larid G, Valayer S, Jacquier C, Lafforgue P, Laredo JD, Pham T. Bisphosphonate treatment in inaccessible osteoid osteomas: An alternative therapeutic approach. Joint Bone Spine 2023; 90:105589. [PMID: 37201577 DOI: 10.1016/j.jbspin.2023.105589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 04/28/2023] [Accepted: 05/08/2023] [Indexed: 05/20/2023]
Abstract
INTRODUCTION Osteoid osteoma is a benign osteogenic tumour traditionally treated by surgical excision or percutaneous CT-guided procedures. We describe three cases of osteoid osteomas of which the locations were difficult to access, or for which the procedure was potentially unsafe, involving treatment with zoledronic acid infusions. CASE DESCRIPTION We report here three male 28-to-31-year-old patients with no medical history who had osteoid osteomas located at the second cervical vertebra, the femoral head, and the third lumbar vertebra respectively. These lesions were responsible for inflammatory pain requiring daily treatment with acetylsalicylic acid. Given the impairment risk, all of the lesions were ineligible for surgical or percutaneous treatment. Patients were successfully treated by 3 to 6 monthly zoledronic acid infusions. All patients experienced complete relief of their symptoms allowing aspirin discontinuation, without any side effects. In the first two cases, CT and MRI control showed nidus mineralization and bone marrow oedema regression, correlating with the pain decrease. After 5years of follow-up, there had been no recurrence of the symptoms. CONCLUSION In these patients, monthly 4mg zoledronic acid infusions have been safe and effective in the treatment of inaccessible osteoid osteomas.
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Affiliation(s)
- Guillaume Larid
- Rheumatology Department, Sainte-Marguerite Hospital, AP-HM, 13009 Marseille, France; Rheumatology Department, Poitiers University Hospital, 86000 Poitiers, France; LITEC Laboratory, University of Poitiers, 86000 Poitiers, France.
| | - Simon Valayer
- Internal Medicine Department, Cochin Hospital, Paris, France
| | - Clémentine Jacquier
- Internal Medicine and Rheumatology Department, Percy Military Teaching Hospital, 92141 Clamart, France
| | - Pierre Lafforgue
- Rheumatology Department, Sainte-Marguerite Hospital, AP-HM, 13009 Marseille, France; Aix-Marseille University, 13284 Marseille, France
| | - Jean Denis Laredo
- Paris Cité University, 75013 Paris, France; Orthopaedic and Trauma Surgery, Lariboisière Hospital, AP-HP, 75010 Paris, France
| | - Thao Pham
- Rheumatology Department, Sainte-Marguerite Hospital, AP-HM, 13009 Marseille, France; Aix-Marseille University, 13284 Marseille, France
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Cerny J, Soukup J, Cerna S, Novotny T. Current Approaches to Osteoid Osteoma and Minimally Invasive Surgery-A Minireview and a Case Report. J Clin Med 2022; 11:jcm11195806. [PMID: 36233673 PMCID: PMC9572602 DOI: 10.3390/jcm11195806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 09/09/2022] [Accepted: 09/27/2022] [Indexed: 11/21/2022] Open
Abstract
Osteoid osteoma is a benign bone tumor typically affecting the long bones of the lower limbs in young male patients. The lesion can be asymptomatic but, in most cases, patients present with characteristic nocturnal pain that is very responsive to the administration of non-steroidal anti-inflammatory drugs. Although osteoid osteomas can regress spontaneously over time, surgical therapy is often indicated in cases of long-lasting resistant pain. Apart from a traditional open resection, the modalities of minimally invasive surgery, such as radiofrequency ablation or cryoablation, have gradually become the option of choice in most cases. The first part of this manuscript is a minireview of the contemporary literature on the pathogenesis, diagnosis, and current trends in the treatment of osteoid osteoma. The second part is a case report of our own experience with a conventional C-arm-guided radiofrequency ablation of an osteoid osteoma located in the femoral neck in an adolescent patient. The aim was to prove that, even when more sophisticated guiding devices (CT, O-arm, etc.) are not available, the safe and reliable ablation of the lesion using a C-arm is still possible even in hard-to-reach areas. The case was a success, with no perioperative or postoperative complications.
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Affiliation(s)
- Jan Cerny
- Department of Orthopaedics, University J.E. Purkinje and Masaryk Hospital, 401 13 Usti nad Labem, Czech Republic
| | - Jan Soukup
- Department of Orthopaedics, University J.E. Purkinje and Masaryk Hospital, 401 13 Usti nad Labem, Czech Republic
- Department of Rehabilitation and Sports Medicine, Second Faculty of Medicine, Charles University and University Hospital Motol, 150 06 Prague, Czech Republic
| | - Sarka Cerna
- Department of Genetics, University J.E. Purkinje and Masaryk Hospital, 401 13 Usti nad Labem, Czech Republic
| | - Tomas Novotny
- Department of Orthopaedics, University J.E. Purkinje and Masaryk Hospital, 401 13 Usti nad Labem, Czech Republic
- Correspondence: ; Tel.: +420-4-7711-3050
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Zeng H, He H, Tong X, Wang Z, Luo R, Liu Q. Osteoid Osteoma of the Proximal Femur: Pitfalls in Diagnosis and Performance of Open Surgical Resection. Front Surg 2022; 9:922317. [PMID: 35836603 PMCID: PMC9273932 DOI: 10.3389/fsurg.2022.922317] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 06/10/2022] [Indexed: 11/13/2022] Open
Abstract
Aims Proximal femoral osteoid osteoma (OO) is extremely easy to be misdiagnosed or missed. The purpose of this study was to retrospectively analyze the clinical data of patients with proximal femoral OO in order to determine the clinical manifestation and imaging characteristics of the disease, so as to provide help for the preoperative diagnosis and clinical treatment of proximal femoral OO. Methods This was a retrospective study involving 35 patients with proximal femoral OO admitted into our hospital from January 2015 to January 2021. The baseline characteristics of the participants included; 24 males and 11 females, aged between 13 and 25 (mean 16.2) years old, and the course of the disease was 1 to 14 (mean 6.3) 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 carried out regularly, and patients advised to avoid strenuous exercises for 3 months. Results We followed up 35 patients (25 intercortical, 4 sub-periosteal, and 6 medullary) for an average of 41.4 months. We found that 15 patients (42.9%) had been misdiagnosed of synovitis, perthes disease, osteomyelitis, intra-articular infection, joint tuberculosis and hip impingement syndrome, whose average time from symptoms to diagnosis were 6.3 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. Wrong choice of examination, and the complexity and diversity of clinical manifestations constitutes the main reasons for the misdiagnosis of proximal femoral OO.
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Affiliation(s)
- Hao Zeng
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China
| | - Hongbo He
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China
| | - Xiaopeng Tong
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zhiwei Wang
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Rongsheng Luo
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Qing Liu
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China
- Correspondence: Qing Liu ;
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Tepelenis K, Skandalakis GP, Papathanakos G, Kefala MA, Kitsouli A, Barbouti A, Tepelenis N, Varvarousis D, Vlachos K, Kanavaros P, Kitsoulis P. Osteoid Osteoma: An Updated Review of Epidemiology, Pathogenesis, Clinical Presentation, Radiological Features, and Treatment Option. In Vivo 2021; 35:1929-1938. [PMID: 34182465 DOI: 10.21873/invivo.12459] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/19/2021] [Accepted: 04/20/2021] [Indexed: 12/12/2022]
Abstract
Osteoid osteoma, the third most common benign bone tumor, usually occurs in the cortex of long bones. It consists of a radiolucent nidus surrounded by reactive osteosclerosis. Generally, osteoid osteoma affects young males. Nocturnal pain that eases with salicylates or nonsteroidal anti-inflammatory drugs (NSAID) is the typical clinical presentation. Sometimes, it remains undiagnosed for a long time. Plain radiography and computed tomography are usually sufficient for the diagnosis of osteoid osteoma. Initial treatment includes salicylates and NSAID because the tumor often regresses spontaneously over 2-6 years. Surgical treatment is indicated in case of unresponsive pain to medical therapy, no tolerance of prolonged NSAID therapy due to side effects, and no willingness to activity limitations. Nowadays, minimally invasive techniques have replaced open surgery and are considered the gold standard of surgical treatment. Although cryoablation seems superior in terms of the nerve damage and immunotherapy effect, radiofrequency ablation is the preferred technique.
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Affiliation(s)
- Kostas Tepelenis
- Department of Surgery, University Hospital of Ioannina, Ioannina, Greece;
| | - Georgios P Skandalakis
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York City, NY, U.S.A
| | | | | | | | - Alexandra Barbouti
- Anatomy - Histology - Embryology, University of Ioannina, Ioannina, Greece
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Celin MR, Simon JC, Krzak JJ, Fial AV, Kruger KM, Smith PA, Harris GF. Do Bisphosphonates Alleviate Pain in Children? A Systematic Review. Curr Osteoporos Rep 2020; 18:486-504. [PMID: 32960409 DOI: 10.1007/s11914-020-00621-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE OF REVIEW The goal of this systematic review is to analyze the effectiveness of bisphosphonates (BPs) to treat bone pain in children and adolescents who have diseases with skeletal involvement. RECENT FINDINGS We included 24 studies (2 randomized controlled trials, 3 non-randomized controlled trials, 10 non-randomized open-label uncontrolled studies, 8 retrospective studies, and 1 study with design not specified). The majority of included studies assessed pain from a unidimensional approach, with pain intensity the most frequently evaluated dimension. Only 38% of studies used validated tools; visual analogue scale was the most frequently employed. BPs were used to alleviate bone pain in a wide variety of pediatrics conditions such as osteogenesis imperfecta, secondary osteoporosis, osteonecrosis related to chemotherapy, chronic non-bacterial osteitis, idiopathic juvenile osteoporosis, unresectable benign bone tumor, and cancer-related pain. Twenty of the 24 studies reported a positive effect of BPs for alleviating pain in different pathologies, but 58% of the studies were categorized as having high risk of bias. Intravenous BPs are helpful in alleviating bone pain in children and adolescents. It is advised that our results be interpreted with caution due to the heterogeneity of the doses used, duration of treatments, and types of pathologies included. In addition, this review shows the paucity of high-quality evidence in the available literature and further research is needed. TRIAL REGISTRATION Before the completion of this review, the protocol was registered to PROSPERO (International prospective register of systematic reviews), PROSPERO 2020 ID # CRD42020158316. Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020158316.
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Affiliation(s)
| | - Jackeline C Simon
- Motion Analysis Center, Shriners Hospitals for Children, Chicago, IL, USA
- Orthopaedic and Rehabilitation Engineering Center, Marquette University, Milwaukee, WI, USA
| | - Joseph J Krzak
- Motion Analysis Center, Shriners Hospitals for Children, Chicago, IL, USA
- Physical Therapy Program, College of Health Sciences, Midwestern University, Downers Grove, IL, USA
| | - Alissa V Fial
- Research and Instructional Services, Raynor Memorial Libraries, Marquette University, Milwaukee, WI, USA
| | - Karen M Kruger
- Motion Analysis Center, Shriners Hospitals for Children, Chicago, IL, USA
- Orthopaedic and Rehabilitation Engineering Center, Marquette University, Milwaukee, WI, USA
| | - Peter A Smith
- Motion Analysis Center, Shriners Hospitals for Children, Chicago, IL, USA
| | - Gerald F Harris
- Motion Analysis Center, Shriners Hospitals for Children, Chicago, IL, USA
- Orthopaedic and Rehabilitation Engineering Center, Marquette University, Milwaukee, WI, USA
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Cazzato RL, Garnon J, De Marini P, Auloge P, Dalili D, Koch G, Antoni D, Barthelemy P, Kurtz JE, Malouf G, Feydy A, Charles YP, Gangi A. French Multidisciplinary Approach for the Treatment of MSK Tumors. Semin Musculoskelet Radiol 2020; 24:310-322. [DOI: 10.1055/s-0040-1710052] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
AbstractSeveral interventional treatments have recently been integrated into the therapeutic armamentarium available for the treatment of bone tumors. In some scenarios (e.g., osteoid osteoma), interventional treatments represent the sole and definitive applied treatment. Due to the absence of widely shared protocols and the complex multivariate scenarios underlying the clinical presentation of the remaining bone tumors including metastases, therapeutic strategies derived from a multidisciplinary tumor board are essential to provide effective treatments tailored to each patient. In the present review, we present the multidisciplinary therapeutic strategies commonly adopted for the most frequent bone tumors.
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Affiliation(s)
- Roberto Luigi Cazzato
- Service d’Imagerie Interventionnelle, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Julien Garnon
- Service d’Imagerie Interventionnelle, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Pierre De Marini
- Service d’Imagerie Interventionnelle, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Pierre Auloge
- Service d’Imagerie Interventionnelle, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Danoob Dalili
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
- Nuffield Orthopaedic Centre, Oxford University Hospitals, NHS Foundation Trust, Oxford, United Kingdom
| | - Guillaume Koch
- Service d’Imagerie Interventionnelle, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Delphine Antoni
- Service de Radiothérapie, Institut de cancérologie Strasbourg Europe (ICANS), Strasbourg, France
| | - Philippe Barthelemy
- Service d’Oncologie Médicale, Institut de cancérologie Strasbourg Europe (ICANS), Strasbourg, France
| | - Jean Emmanuel Kurtz
- Service d’Oncologie Médicale, Institut de cancérologie Strasbourg Europe (ICANS), Strasbourg, France
| | - Gabriel Malouf
- Service d’Oncologie Médicale, Institut de cancérologie Strasbourg Europe (ICANS), Strasbourg, France
| | - Antoine Feydy
- Service de Radiologie, Hôpital Cochin, APHP, Université Paris V, Paris, France
| | - Yan-Philippe Charles
- Service de Chirurgie du Rachis, Hôpitaux Universitaires de Strasbourg, Fédération de Médecine Translationnelle (FMTS), Université de Strasbourg, Strasbourg, France
| | - Afshin Gangi
- Service d’Imagerie Interventionnelle, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
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Abstract
Osteoid osteoma (OO), a small bone tumor relatively common in young subjects, frequently involves the hip. In addition to typical findings, we emphasize unsuspected clinical and imaging features including painless OO causing limping gait, non-visibility of totally mineralized nidus, absence of hyperostosis or adjacent edema, and recurrence at distance from the initial location. We also discuss the option of medical treatment for some cases of deep hip locations.
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Rolvien T, Krause M, Zustin J, Yastrebov O, Oheim R, Barvencik F, Frosch KH, Amling M. Intra-articular osteoid osteoma accompanied by extensive bone marrow edema. A clinical and micro-morphological analysis. J Bone Oncol 2019; 18:100256. [PMID: 31497501 PMCID: PMC6722254 DOI: 10.1016/j.jbo.2019.100256] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 08/16/2019] [Accepted: 08/19/2019] [Indexed: 12/18/2022] Open
Abstract
A series of patients with intra-articular osteoid osteoma (OO) is demonstrated. Extensive and persistent bone marrow edema syndrome masked the correct diagnosis. No consistent patterns of impaired bone mineral status could be confirmed in these patients. Nidus specimens displayed significantly higher mineralization heterogeneity determined by qBEI.
Osteoid osteoma (OO) is a benign bone tumor producing non-mineralized bone matrix (i.e., osteoid). While peritumoral edema is commonly found in OO, extensive bone marrow edema has been reported less frequently. Furthermore, the micro-morphological characteristics of the nidus and its central calcification remain unclear. In this study, a consecutive series of four patients suffering from extensive bone marrow edema triggered by intra-articular osteoid osteoma underwent clinical examination, magnetic resonance imaging (MRI) and computed tomography (CT) as well as dual-energy X-ray absorptiometry (DXA) and laboratory bone turnover analyses. The obtained resection specimens were processed by undecalcified histology and were subsequently analyzed by light microscopy and quantitative backscattered electron imaging (qBEI). We report an entity of intra-articular osteoid osteoma in the knee and foot, in which an extensive and persistent bone marrow edema syndrome masked the correct diagnosis. While metabolic bone diseases were excluded in all cases, the reassessment of the patients’ clinical history including pain characteristics (nocturnal, aspirin sensitivity) led us to perform additional CT, where the tumor was diagnosed. The micro-morphological analysis of the OO biopsies revealed that the nidus was surrounded by hyperosteoidosis, while central mineralization was detected in all cases. This mineralized area showed a significantly higher mineralization heterogeneity than the surrounding trabecular bone and more disorganized collagen fibers detected by qBEI and polarized light microscopy, respectively. Taken together, our results indicate that osteoid osteoma should be considered when persistent and extensive, peri-articular bone marrow edema is diagnosed. The central calcification that is found inside the nidus in conventional imaging was mirrored by bone matrix with a heterogeneous mineralization pattern.
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Affiliation(s)
- Tim Rolvien
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Orthopedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Corresponding author at: Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 59, 22529 Hamburg, Germany.
| | - Matthias Krause
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Trauma, Hand and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jozef Zustin
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Pathologisch-Anatomisches Institut Regensburg, Regensburg, Germany
| | - Oleg Yastrebov
- Department of Foot Surgery, Agaplesion Diakonieklinikum, Hamburg, Germany
| | - Ralf Oheim
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Florian Barvencik
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Karl-Heinz Frosch
- Department of Trauma, Hand and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael Amling
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Corresponding author.
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Highlights of the special scientific sessions of the 45th Annual Scientific Meeting of the International Skeletal Society (ISS) 2018, Berlin, Germany. Skeletal Radiol 2019; 48:187-189. [PMID: 30406833 DOI: 10.1007/s00256-018-3112-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 10/30/2018] [Indexed: 02/02/2023]
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13
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Noordin S, Allana S, Hilal K, Nadeem N, Lakdawala R, Sadruddin A, Uddin N. Osteoid osteoma: Contemporary management. Orthop Rev (Pavia) 2018; 10:7496. [PMID: 30370032 PMCID: PMC6187004 DOI: 10.4081/or.2018.7496] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 03/06/2018] [Accepted: 03/18/2018] [Indexed: 11/23/2022] Open
Abstract
Osteoid osteoma is a benign bone-forming tumor with hallmark of tumor cells directly forming mature bone. Osteoid osteoma accounts for around 5% of all bone tumors and 11% of benign bone tumors with a male predilection. It occurs predominantly in long bones of the appendicular skeleton. According to Musculoskeletal Tumor Society staging system for benign tumors, osteoid osteoma is a stage-2 lesion. It is classified based on location as cortical, cancellous, or subperiosteal. Nocturnal pain is the most common symptom that usually responds to salicyclates and non-steroidal anti-inflammatory medications. CT is the modality of choice not only for diagnosis but also for specifying location of the lesion, i.e. cortical vs sub periosteal or medullary. Non-operative treatment can be considered as an option since the natural history of osteoid osteoma is that of spontaneous healing. Surgical treatment is an option for patients with severe pain and those not responding to NSAIDs. Available surgical procedures include radiofrequency (RF) ablation, CT-guided percutaneous excision and en bloc resection.
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Affiliation(s)
| | - Salim Allana
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Kiran Hilal
- Department of Radiology, Aga Khan University, Karachi, Pakistan
| | - Naila Nadeem
- Department of Radiology, Aga Khan University, Karachi, Pakistan
| | - Riaz Lakdawala
- Orthopaedic Surgery, Aga Khan University, Karachi, Pakistan
| | - Anum Sadruddin
- Department of Surgery, Aga Khan University, Karachi, Pakistan
| | - Nasir Uddin
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
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Gałęzowska J, Czapor-Irzabek H, Chmielewska E, Kafarski P, Janek T. Aminobisphosphonates based on cyclohexane backbone as coordinating agents for metal ions. Thermodynamic, spectroscopic and biological studies. NEW J CHEM 2018. [DOI: 10.1039/c8nj01158c] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Complex formation equilibria of calcium, magnesium, copper and nickel with amino-bisphosphonic ligands are described, together with a speciation study along with calorimetric outcome and cytotoxicity characteristics.
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Affiliation(s)
- J. Gałęzowska
- Department of Inorganic Chemistry
- Wrocław Medical University
- Wrocław 50-556
- Poland
| | - H. Czapor-Irzabek
- Laboratory of Elemental Analysts and Structural Research
- Wrocław Medical University
- Wrocław 50-556
- Poland
| | - E. Chmielewska
- Department of Bioorganic Chemistry
- Faculty of Chemistry
- Wrocław University of Science and Technology
- Wrocław
- Poland
| | - P. Kafarski
- Department of Bioorganic Chemistry
- Faculty of Chemistry
- Wrocław University of Science and Technology
- Wrocław
- Poland
| | - T. Janek
- Department of Inorganic Chemistry
- Wrocław Medical University
- Wrocław 50-556
- Poland
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