Quantitation of porcine reproductive and respiratory syndrome virus RNA in semen by single-tube reverse transcription-nested polymerase chain reaction

The diagnosis of osteoid osteoma can be difficult. We present eight children where the diagnosis of osteoid osteoma was difficult, due to a clinical history suggesting an alternative diagnosis, misleading radiological findings, or where the osteoid osteoma was in an unusual site. In some cases, diagnosis was only reached after biopsy, despite radiological investigation and radioisotope studies. The diagnosis should be considered in a child with bony pain or bony swelling, especially where the history is a chronic one. We present a radiological algorithm for the investigation of patients suspected of having an osteoid osteoma.     

Imaging of huge lingual thyroid gland with goitre

One year after a nonspecific trauma and with a history of pain of four weeks only, an osteoid osteoma of the first phalanx of the left thumb was diagnosed in a 31-year-old man. The radiologic appearance as well as a bone scan were suggestive for an osteoid osteoma. The diagnosis was confirmed histologically after resection of the tumor. As indicated in the literature, osteoid osteoma of the hand is relatively rare. The symptoms and radiologic features (osteolytic nidus and sclerosis) of osteoid osteomas are independent of the tumor location. Surgery with resection of the nidus is the only known curative therapy. The etiological role of trauma is discussed and a review of the literature is done with 15 other cases of posttraumatic osteoid osteoma having been reported.     

Osteoid osteoma in a three-year-old child--a case report

Osteoid osteoma is an uncommon tumour in the very young. We present a case of osteoid osteoma in a three-year-old boy, who was treated as a case of sclerosing osteomyelitis of the femur. Because of persistent pain and lack of response to treatment, further radiological investigation confirmed the diagnosis to be that of an osteoid osteoma.     

Osteoid osteoma of the pubic bone. Report of a case

Osteoid osteoma involves the pubic bone in exceptional cases. In this case report, a 23 year-old male patient with osteoid osteoma of the pubic bone, was presented. He was complaining of right groin pain, occurring nocturnally and being relieved by rest and analgesics. Radiographic examination revealed a small lesion in the right pubic bone. The patient was treated surgically, and the nidus was excised. The result of the histopathological examination was "osteoid osteoma". At 1 year postoperatively, recurrence was not seen. It was concluded that, if osteoid osteoma was located in an unusual site, more detailed radiographic examination should be done for exact localization, before the operation.     

Percutaneous laser photocoagulation of spinal osteoid osteomas under CT guidance

BACKGROUND AND PURPOSE: Spinal osteoid osteomas are rare; when they occur, they are usually treated by surgical or percutaneous excision. The aim of percutaneous interstitial laser photocoagulation (ILP) of osteoid osteomas under CT guidance is thermal destruction of the nidus using low-power laser energy, thus precluding bone resection and open surgery. METHODS: Three cases of spinal osteoid osteomas were treated with percutaneous ILP of the nidus. Under CT guidance, the needle was positioned in the center of the nidus, at least 8 mm from neurologic structures. Using a high-power semiconductor diode laser (805 nm) with a 400-microm optical fiber, we delivered 600 to 800 joules to the nidus, depending on its size. The procedure was performed with the patient under neuroleptanalgesia and required overnight hospitalization. RESULTS: Complete pain relief was obtained in all three patients within 24 hours of the procedure, and no major complications were incurred. Follow-up ranged from 20 months to 60 months. CONCLUSION: Percutaneous ILP of spinal osteoid osteoma is a promising, simple, precise, and minimally invasive technique and may be an alternative to traditional surgical and percutaneous ablations.     

Discrete synchronous multifocal osteoid osteoma of the humerus

A 24-year-old patient is described who had a 4-year history of pain in the right upper arm, with distinct night pain, that responded to salicylates. From the findings on conventional radiography, bone scintigraphy and MRI a multifocal osteoid osteoma was suspected, with one focus in the cancellous region of the greater tuberosity and a second cortical focus at the proximal humeral diaphysis. The resection "en bloc" of both tumors and histological examination confirmed the diagnosis. The patient was painfree after the curative resection of the two osteoid osteomas. Osteoid osteoma is a frequently found benign bone tumor, accounting for approximately 11% of cases. In rare cases a multicentric occurrence has been described. A possible occurrence of more than one osteoid osteoma in a single bone, not verified histologically, has been reported only three times in the literature. In patients with scintigraphic and radiographic findings of two foci, discrete synchronous multifocal osteoid osteomas should be suspected.     

MRI in the diagnosis of osteoid osteoma

INTRODUCTION: Osteoid osteoma (OO) is a frequently encountered benign bone tumor, seen in young adults with male predominance. MATERIALS AND METHODS: Nine patients complaining of nonspecific extremity pain underwent MRI examination. The sequences obtained were T1 and T2 weighted spin-echo and T2 weighted gradient echo. A CT scan examination followed in all cases, exploring the region of the abnormal signal seen on MRI. The results of both examinations were compared. RESULTS: In six of the nine patients (66.6%) MRI showed evidence suggestive of osteoid osteoma, comparable that seen on CT scan. In three patients (33.3%), MRI showed a nonspecific and ill-defined bone marrow signal abnormality. CT cuts focused on those areas of signal abnormality showed the nidus. DISCUSSION: MRI is more sensitive than CT scan in detecting soft tissue and bone marrow abnormalities adjacent to an osteoid osteoma. This may produce a misleading aggressive appearance on MR images. CT scanning is more specific than MRI, by showing the nidus. In three patients studied, the nidus was only seen by CT, the other six osteoid osteomas were equally seen by CT and by MRI. In our study, MRI revealed abnormalities in all the cases. It was also highly specific for osteoid osteoma in 66.6%. CONCLUSION: MRI is very sensitive in detecting bone marrow and soft tissue abnormalities, and can suggest the diagnosis of OO in a good number of patients. In the remainder cases MRI guides the CT-scan. CT is more accurate and remains the definite examination for the diagnosis of OO, by showing the nidus.     

Pneumocystis carinii pneumonia in HIV primary infection]

We report a case of osteoid osteoma as a cause of hip pain in a young athlete. Excision of the lesion resulted in complete relief of the symptoms.     

Project for the development of an ambulatory and semi-ambulatory community center for the third age

A case of osteoid osteoma of the scaphoid was discovered, in the absence of radiological (conventional and CT-scan) alterations. MRI findings were not conclusive.     

Adenoviral gene transfer in arteries of hypercholesterolemic nonhuman primates

Osteoid osteoma, a benign bone tumor, has traditionally been treated with operative excision. A recently developed method for percutaneous ablation of the tumor has been proposed as an alternative to operative treatment. The relative outcomes of the two approaches to treatment have not previously been compared, to our knowledge. The rates of recurrence and of persistent symptoms were compared in a consecutive series of eighty-seven patients who were managed with operative excision and thirty-eight patients who were managed with percutaneous ablation with radiofrequency. Patients who had a spinal lesion were excluded. The minimum duration of follow-up was two years. There was a recurrence, defined as the need for subsequent intervention, after operative treatment in six (9 per cent) of sixty-eight patients who had been managed for a primary lesion and in two of nineteen who had been managed for a recurrent lesion. The average length of the hospital stay was 4.7 days for the patients who had a primary lesion and 5.1 days for those who had a recurrent lesion. There was a recurrence after percutaneous treatment in four (12 per cent) of thirty-three patients who had been managed for a primary lesion and in none of five who had been managed for a recurrent lesion. The average length of the hospital stay was 0.2 day for these thirty-eight patients. With the numbers available, we could detect no significant difference between the two treatments with regard to the rate of recurrence. The rate of persistent symptoms (that is, symptoms that did not necessitate additional treatment) was greater than the rate of recurrence. According to responses to a questionnaire, eight (30 per cent) of twenty-seven patients had persistent symptoms after operative treatment and six (23 per cent) of twenty-six patients had persistent symptoms after percutaneous treatment with radiofrequency. Two patients had complications after operative excision, necessitating a total of five additional operations. There were no complications associated with the percutaneous method. The results of the present study suggest that percutaneous ablation with radiofrequency is essentially equivalent to operative excision for the treatment of an osteoid osteoma in an extremity. The percutaneous method is preferred for the treatment of extraspinal osteoid osteoma because it generally does not necessitate hospitalization, it has not been associated with complications, and it is associated with a rapid convalescence.     

Osteoid osteoma of the petrous bone

We present a case of osteoid osteoma of the petrous bone presenting with progressive sensorineural hearing loss. CT showed a dense homogeneous mass at the promontory surrounded by a thin bony border. On MRI this lesion gave intermediate signal intensity on T1- and T2-weighted spin-echo images and enhanced intensely with gadolinium. Surgical removal and pathological study proved the diagnosis.     

Pain in osteoid osteoma: histological facts

Six cases of osteoid osteoma were studied histologically using the Gross technique. When the nidus is located centrally, it is reached by amyelinic fibers accompanying the vessel branches or as independent fibers. The pain is generally considered to reflect changes in vessel pressure and it could also be due to direct irritation of the nerve fibers included in or near the calcification focus.     

Interventional radiology with laser in bone and joint

Laser energy is able to ablate, coagulate, and vaporize tissues. Its transmissibility in thin optical fibers makes it an ideal tool for use in percutaneous procedures. This article describes two applications in interventional musculoskeletal radiology. In percutaneous laser disc decompression the laser source is used to vaporize a small portion of the nucleus pulposus. In interstitial laser photocoagulation of osteoid osteoma the laser energy is used to coagulate and destroy the tumor by direct heating.     

Assessing the limping child with skeletal scintigraphy

Skeletal scintigraphy is frequently used in the clinical investigation of young children who present with limping as their only or predominant symptom. This article reviews techniques used for pediatric skeletal scintigraphy, skeletal tracer distribution in the immature skeleton and scintigraphic manifestations of relatively common conditions that can produce limping in children 1-6 yr old. Acute osteomyelitis, vertebral infections, transient synovitis, septic arthritis, Legg-Calvé-Perthes disease, lower extremity injuries in toddlers and osteoid osteoma are emphasized.     

Percutaneous therapy of osteoid osteoma

Osteoid osteomas are tumors with intense clinical symptoms and extensive reactive bone changes far exceeding the volume of the lesion itself. Because of their small size they can be approached by minimally invasive surgical procedures. We treated ten symptomatic patients with osteoid osteomas (n 6 hip point, n 1 iliac bone, n 1 femoral diaphysis, n 2 tibial diaphysis) by excision of the nidus with a 3-mm Harlow-Wood needle using a percutaneous CT-guided approach. Seven patients with residual tumor were treated with either thermocautery (n 2) or sclerosis with 1 ml of 96% ethanol (n 5). Six patients had instant and constant relief (3 years' observation) of their pain. In two patients a second transcutaneous intervention was successful. Only two patients needed open resection. Compared with the invasive open resection of the tumors, sometimes even putting the stability of the femoral neck at risk, transcutaneous CT-guided enucleation of the nidus of the osteoid osteoma with additional sclerotherapy is a good alternative method, especially in the region of the femoral neck.     

Pain provoked scoliosis. Observations on the evolution of the deformity

The case reports of 5 children with scoliosis provoked by painful vertebral lesions of osteoid osteoma and eosinophilic granuloma reveal that the final outcome of the deformity is determined by the interaction of 2 factors: the age of the child (in relation to his growth velocity); the duration of symptoms. Complete resolution in 2 children with scoliosis of 10 months' and one year's duration respectively, and partial regression of a curve which has been present for 6 years in another child draws attention to the fact that spontaneous correction of structural scoliosis can and does occur in a growing child. In the light of this and other evidence it is suggested that early idiopathic scoliosis could possess the potential for spontaneous correction.     

Phyllodes tumour in pregnancy: a case report

An 18 1/2-year-old castrated male donkey with progressively worsening right forelimb lameness presented with a mass on the distal dorsal aspect of its P3 bone. Grossly, the firm, gritty mass was infiltrative, disrupted the contours of the overlying hoof wall, and had mottled and cavitated areas on cut surface. Histologically, the growth was composed of densely cellular sheets of mildly pleomorphic mesenchymal cells forming irregularly shaped islands of poorly mineralized osteoid. The neoplastic mass had patchy areas of necrosis. The diagnostic possibilities considered for this donkey's mass include osteosarcoma, osteoma, ossifying fibroma, and fibrous dysplasia. Careful consideration of the gross and histological characteristics of this donkey's mass support a diagnosis of osteosarcoma.     

Differential diagnosis of benign spinal neoplasms

The authors analyze problems arising in differential diagnosis of benign spinal tumors not adequately described in available literature. The most characteristic x-ray symptoms of rare spinal tumors are presented. Methods of radiologic investigation such as polipositional roentgenography, tomography, roentgenography with direct image amplification are described in detail. A total of 102 observations of benign spinal tumors are analyzed: osteoblaclastomas responsible for 14.7% of osteoblastoclastomas, angiomas responsible for 66.7% of cases, osteochondroma occurring in 6.7% of cases, chordomas and osteoid ostema occurring in 10.7 and 1.0% of cases, respectively.     

When to use bone scintigraphy. It can reveal things other studies cannot

Despite advances in nuclear medicine, bone scintigraphy remains an important imaging technique. It is sensitive in detecting stress fractures and bone metastases and can assess suspected injury that is difficult to see on plain films (e.g., rib fracture). Scintigraphy is useful in evaluating new symptoms, response to therapy, and prognosis in patients with known malignant tumor. In patients with low back pain, the technique can determine the age of fractures to help identify osteoporosis and can uncover other causes of the pain (e.g., spondylolysis, arthritis). When Paget's disease is suggested by unexplained bone pain or an elevated serum alkaline phosphatase level, bone scintigraphy is a useful screening test. Combined with other appropriate nuclear medicine studies, it helps in early identification and localization of osteomyelitis. Scintigraphic scans can provide a general indicator of malignant versus benign disease (according to the amount of lesion activity seen) and may produce characteristic findings in certain primary tumors (e.g., osteoid osteoma) that are difficult to evaluate with other methods.     

Bone tumors of the coracoid process of the scapula

Bone tumors of the coracoid process of the scapula are rare, and diagnosis and treatment often are delayed. The records of 18 patients with bone tumors of the coracoid process were reviewed. Histologic types included eight cases of ordinary chondrosarcoma, three cases of dedifferentiated chondrosarcoma, two cases of osteoid osteoma, and one case each of osteosarcoma, plasmacytoma, lymphoma, giant cell tumor, and aneurysmal bone cyst. All 18 patients had shoulder pain, and eight of them had been treated with steroid injections for nonneoplastic conditions. Radiologically, chondrosarcoma did not always show clear cortical destruction, and one giant cell tumor had features mimicking those of chondrosarcoma. Five patients (three with dedifferentiated chondrosarcoma, one with chondrosarcoma, one with plasmacytoma) died of disease. The coracoid process was the site with a markedly high proportion of chondrosarcomas. Bone tumors of the coracoid process may be difficult to detect on plain radiographs. In the patient with persistent shoulder pain unresponsive to the selected treatment, additional imaging studies should be considered to eliminate the possibility of a bone lesion.