PDF(Pubmed)
Abstract：
Osteoid osteomas are benign, typically intracortical lesions most often affecting the diaphysis of long bones. Nocturnal pain and characteristic symptoms that are relieved by administration of non-steroidal anti-inflammatory drugs (NSAIDs) are present and can help in the diagnosis of osteoid osteoma. We report a case of 18-year-old boy with an osteoid osteoma in the olecranon fossa with an atypical clinical manifestation. The initial manifestation was arthritis-like symptoms such as local heat, motion pain rather than pain at rest, and limited range-of-motion. Notably, NSAIDs were not effective at all for relieving his symptoms. Magnetic resonance imaging showed bone marrow edema around the elbow joint. The symptoms were resistant to conservative treatments, and thus, surgical resection was required. Histopathological examination showed that the lesion consisted of woven bones and osteoid tissues that anastomosed with each other. Combined with a tumor size that was less than 2 cm, clinicopathologically, the tumor was diagnosed as an osteoid osteoma. The pain was immediately relieved after the operation, and range-of-motion recovered at 2 months postoperatively. At 1 year after the surgery, the patient did not exhibit recurrence of the tumor or exacerbation of elbow pain and had a full range of elbow motion. Osteoid osteoma should be considered for the differential diagnosis of arthritis of the elbow in patients who are adolescents and young adults, which is the peak age of onset for osteoid osteoma.
摘要：
骨样骨瘤是良性的,典型的皮质内病变最常影响长骨的骨干。通过施用非甾体类抗炎药（NSAIDs）可以缓解夜间疼痛和特征性症状，可以帮助诊断骨样骨瘤。我们报告了一例18岁男孩，其尺骨鹰嘴窝有骨样骨瘤，临床表现不典型。最初的表现是关节炎样症状，如局部发热，运动疼痛而不是休息时的疼痛，和有限的运动范围。值得注意的是,NSAIDs根本不能有效缓解他的症状。磁共振成像显示肘关节周围骨髓水肿。症状对保守治疗有抵抗力，因此，需要手术切除.组织病理学检查显示，病变由相互吻合的编织骨和类骨组织组成。结合肿瘤大小小于2厘米，临床病理,肿瘤被诊断为骨样骨瘤。术后疼痛立即缓解,术后2个月活动范围恢复。手术后一年，患者未出现肿瘤复发或肘部疼痛加重,肘部活动范围很广.在青少年和年轻人的肘关节关节炎的鉴别诊断中，应考虑骨样骨瘤，这是骨样骨瘤发病的高峰年龄。
