Osteoma, Osteoid

骨瘤,骨样
  • 文章类型: Review
    背景:骨样骨瘤(OO)是一种良性病变,其特征是骨髓中的纤维成分增加,髓腔内存在骨样结构,和周围的硬化骨缘。关于位于胫骨近端后部的OO的报道很少。
    方法:这里,我们报道了一个18岁男性的病例,入院评估右膝疼痛。右膝疼痛在6个月前开始,没有任何明显的原因,晚上特别严重,影响睡眠,并在爬楼梯或承重时加剧。患者还经历了屈曲疼痛。三维计算机断层扫描和磁共振成像显示,右胫骨后内侧平台的皮质骨下方有结节性病变,并且异常信号集中在右胫骨平台的后外侧,并伴有广泛的骨髓水肿。右膝关节囊中存在少量液体。患者随后接受了OO的关节镜切除。术后,疼痛明显减轻,膝盖的活动范围恢复正常.
    结论:尽管胫骨近端后部的OO很少发生,它可以通过微创关节镜可视化有效地切除。
    BACKGROUND: Osteoid osteoma (OO) is a benign lesion characterized by an increased fibrous component in the bone marrow, presence of bone-like structures within the medullary cavity, and a surrounding sclerotic bone rim. Reports on OO located in the posterior proximal tibia are rare.
    METHODS: Herein, we report the case of an 18-year-old male, admitted for the evaluation of right knee pain. The right knee pain had started 6 months prior without any apparent cause, which was notably severe at night, affecting sleep, and was exacerbated while climbing stairs or bearing weight. The patient also experienced pain on flexion. Three-dimensional computed tomography and magnetic resonance imaging revealed a nodular lesion beneath the cortical bone of the posterior medial plateau of the right tibia and an abnormal signal focus on the posterior lateral aspect of the right tibial plateau associated with extensive bone marrow edema. A small amount of fluid was present in the right knee joint capsule. The patient subsequently underwent arthroscopic excision of the OO. Postoperatively, there was significant relief of pain, and the knee range of motion returned to normal.
    CONCLUSIONS: Although OO in the posterior proximal tibia is a rare occurrence, it can be effectively excised through minimally invasive arthroscopic visualization.
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  • 文章类型: Systematic Review
    骨样骨瘤是最常见的良性肌肉骨骼肿瘤之一。射频消融是非保守治疗骨样骨瘤的首选方法。最近,高强度聚焦超声(HIFU)已被提出作为一种更安全的选择。本研究的目的是回顾HIFU在骨样骨瘤治疗中的疗效和副作用。在PubMed进行了全面搜索,科学直接,和临床关键,直到2022年6月30日。人口统计数据,基线特征,成功率,术前和术后疼痛评分,复发,并记录并发症。本系统综述包括11项研究。涉及186名受试者的汇总分析的总体成功率为91.94%。在两项研究中报告了复发,其中发生在4/177(2.26%)受试者中。皮肤烧伤1例(0.54%)。未报告重大或其他并发症。三项研究比较了HIFU和RFA的成功率。RFA组的成功率略高,差异无统计学意义(p=0.15)。高强度聚焦超声显示了有希望的结果。它为骨样骨瘤提供了一种更安全的治疗方法,尤其是在儿童中,并且可以考虑RFA后的顽固性病例。尽管如此,预计将来会有更多的研究。
    Osteoid osteoma is one of the most frequent benign musculoskeletal neoplasm. Radiofrequency ablation is the method of choice for non-conservative treatment of osteoid osteoma. Recently, high-intensity focused ultrasound (HIFU) has been proposed as a safer option. The objective of this study is to review the efficacy and side effects of HIFU in the management of osteoid osteoma. A comprehensive search was conducted in PubMed, Science Direct, and Clinical Key until June 30, 2022. Demographic data, baseline characteristics, success rates, pre- and post-procedure pain scores, recurrences, and complications were recorded. Eleven studies were included in this systematic review. Pooled analysis that involved 186 subjects resulted in an overall success rate of 91.94%. Recurrence was reported in two studies, in which it occurred in 4/177 (2.26%) subjects. Skin burn was found in 1 (0.54%) patients. No major or other complications were reported. Three studies compared the success rate of HIFU and RFA. Success rate was slightly higher in the RFA group with insignificant difference (p = 0.15). High-intensity focused ultrasound showed promising results. It offers a safer treatment approach for osteoid osteoma, especially in children, and can be considered for recalcitrant cases after RFA. Nonetheless, more studies are expected in the future.
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  • 文章类型: Meta-Analysis
    目的:磁共振引导聚焦超声(MRgFUS)是一种新型的非侵入性骨样骨瘤(OO)介入技术。这项研究的目的是通过对MRgFUS治疗前后疼痛评分和治疗后不良事件的系统评价和荟萃分析,评估MRgFUS治疗OO的有效性和安全性。
    方法:对PubMed,Embase,WebofScience,和CochraneLibrary数据库进行筛选,根据纳入和排除标准筛选研究文献,以提取和分析治疗前后的疼痛评分数据,成功率(完全缓解疼痛,直到最后一次随访才复发),复发率,二级干预率,和并发症,以评估MRgFUS用于OO的疗效和/或安全性。
    结果:共收集了2012年至2022年间发表的113项研究,导致总样本量为353名患者。大多数研究是前瞻性的,随访时间为4周或更长时间,总的来说,证据质量从低到高不等。合并后1周和1个月疼痛评分分别为0.62(9.5%CI:0.28-0.96)和0.37(9.5%CI:0.07-0.68),分别。组合的成功率为92.8%(95%CI:89.8%-95.7%),轻微并发症(消融部位热损伤)的发生率为0.85%,纳入的任何文献均未记录到重大并发症.
    结论:MRgFUS是一种有效的方法,能够治疗OO患者的疼痛,具有令人满意的疗效和安全性。
    编号.CRD42023415573。
    OBJECTIVE: Magnetic resonance-guided focused ultrasound (MRgFUS) is a novel noninvasive interventional technique for osteoid osteoma (OO). The purpose of this study was to evaluate the efficacy and safety of MRgFUS in the treatment of OO through a systematic review and meta-analysis of pain scores and post-treatment adverse events before and after MRgFUS treatment.
    METHODS: A comprehensive literature search of PubMed, Embase, Web of science, and Cochrane Library databases was conducted to screen the study literature based on inclusion and exclusion criteria to extract and analyze pre- and post-treatment pain score data, success rates (complete pain relief with no recurrence until the last follow-up), recurrence rates, secondary intervention rates, and complications to evaluate the efficacy and/or safety of MRgFUS for OO.
    RESULTS: A total of 113 studies published between 2012 and 2022were collected, resulting in a total sample size of 353 patients. The majority of the studies were prospective and had a follow-up period of 4 weeks or more, and overall, the quality of evidence ranged from low to high. Pain scores at 1 week and 1 month after the merger were 0.62 (9.5% CI:0.28-0.96) and 0.37 (9.5% CI:0.07-0.68), respectively. The success rate of the combination was 92.8% (95% CI: 89.8%-95.7%), the incidence of minor complications (thermal injury at the ablation site) was 0.85%, and no major complications were recorded in any of the included literature.
    CONCLUSIONS: MRgFUS is an effective procedure that is able to treat pain for patients with OO with satisfying efficacy and safety.
    UNASSIGNED: No.CRD42023415573.
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  • 文章类型: Review
    楔形骨的骨样骨瘤是一种极为罕见且容易引起脚痛的原因。这种关节内骨样骨瘤的非特征性和非特异性X光片进一步增加了诊断的难度。迄今为止,在任何已发表的文献中,都没有关于中间楔形骨的关节内骨样骨瘤引起关节变性的描述。我们介绍了一例中间楔形骨的关节内骨样骨瘤,引起关节变性。接受刮宫的人,同种异体骨移植,和舟骨楔形关节固定术。患者表现为影像学骨愈合,在22个月的随访中,完全的运动功能恢复和无痛。此报告增加了现有文献。中间楔形骨的关节内骨样骨瘤导致关节变性是一种极为罕见且容易错过的脚痛原因。事实证明,识别关节内骨样骨瘤是一项复杂而具有挑战性的任务。临床医生应该特别小心,不要排除关节炎的可能性,因此,在选择手术时保持警惕。
    Osteoid osteoma of the cuneiform bone is an exceedingly rare and easily missed cause of foot pain. The uncharacteristic and nonspecific radiographs of such intra-articular osteoid osteoma further increase difficulty in making the diagnosis. To date, there has been no description of intra-articular osteoid osteoma of the intermediate cuneiform bone causing articular degeneration in any published literatures. We present a case of intra-articular osteoid osteoma of the intermediate cuneiform bone causing articular degeneration, who underwent curettage, allograft bone graft, and navicular-cuneiform arthrodesis. The patient presented with radiographic bone union, full motor function recovery and pain-free at the 22-month follow-up. This report adds to the existing literature. Intra-articular osteoid osteoma of the intermediate cuneiform bone causing articular degeneration is an exceedingly rare and easily missed cause of foot pain. It proves a complicated and challenging task to identify intra-articular osteoid osteoma. Clinicians should be particularly careful not to exclude the possibility of arthritis and, thus, vigilant when choosing the surgical option.
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  • 文章类型: Systematic Review
    背景:骨样骨瘤(OO)是一种常见的良性骨肿瘤。OO在长骨中最常见,尤其是胫骨和股骨.当发生在手的骨骼中时,OO可能是诊断和治疗的挑战。这项研究的目的是提供一个系统的事件回顾,症状,关于手部骨骼OO的诊断和治疗选择。
    方法:我们对文献进行了系统回顾。来自在线数据库PubMed和SpringerLink的所有研究,报告了手部骨骼中的骨样骨瘤病例,包括在内。通过对文献的总结,我们评估了手部定位以及诊断和治疗方案.
    结果:我们纳入了133项研究,报告401例病例。OO在指骨中很常见。诊断主要是通过CT(计算机断层扫描)扫描得出的。大多数OO均通过开放刮治或整块切除术进行手术治疗。
    结论:手骨中的骨样骨瘤很少见,延迟诊断很常见。在疼痛结合特定症状如指甲肥大和肿胀的情况下,应考虑OO。在最常用的成像方法中,CT扫描具有最高的灵敏度。
    BACKGROUND: Osteoid osteoma (OO) is a common benign bone tumor. OO is observed most frequently in the long bones, especially in the tibia and femur. When occurring in the bones of the hand, OO can be a diagnostic and therapeutic challenge. The aim of this study was to provide a systematic review of occurrence, symptoms, diagnosis and treatment options regarding OO in hand bones.
    METHODS: We performed a systematic review of the literature. All studies from the online databases PubMed and SpringerLink, which reported cases of osteoid osteomas in the bones of the hand, were included. By summarizing the literature, we evaluated the localization within the hand as well as diagnostic and therapeutic options.
    RESULTS: We included 133 studies reporting 401 cases. OO was mostly common in the phalanges. The diagnosis was mostly made by CT (computed tomography) scan. Most of the OO were treated surgically by open curettage or en bloc resection.
    CONCLUSIONS: Osteoid osteomas in the bones of the hand are rare and a delayed diagnosis is common. In cases of pain combined with particular symptoms such as nail hypertrophy and swelling OO should be considered. Of the most used imaging methods, CT scans have the highest sensitivity.
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  • 文章类型: Meta-Analysis
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  • 文章类型: Meta-Analysis
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  • 文章类型: Meta-Analysis
    Osteoid osteoma (OO) is a primary benign tumor that affects mainly young patients. Ten percent of all OO are located in the vertebral column. Treatment of spinal OO is challenging and there is no consensus in the literature on the best operative approach.
    The aim of this systematic review and meta-analysis was to determine safety and efficacy of radiofrequency ablation (RFA) versus surgical excision for the treatment of spinal OO.
    A literature search was performed on PubMed, Web of Science, and Embase from inception up to 22 March 2022. Studies addressing surgical excision or RFA for the treatment of spinal OO were included. The main outcomes evaluated were pain before and after intervention, the treatments success rate, defined as complete pain relief with no recurrence until the last follow-up, and the number and type of complications.
    Thirty-one studies (749 patients) were included. For patients who underwent surgical excision, 19 studies reported a mean treatment success rate of 85.6%, while in the RFA treatment group, 18 studies reported a mean success rate of 88.6%. At last follow-up, the pooled mean difference in pain scores from baseline on a 0-10 scale was 5.8 points in the surgical excision group and 6.7 points in the RFA group. Recurrences were observed in 5.6% of the patients who underwent surgical excision and in 6.7% of the patients treated with RFA. The complication rate was 7.8% in the surgical excision group and 4.4% in the RFA group.
    This meta-analysis found high global success rates for both surgical and RFA treatments. Both treatments were efficient in pain relief and presented a low rate of recurrences. The complication rate was low for both treatments. Compared to surgical excision, RFA is a less invasive procedure which proved to be a safe and as effective option for the treatment of spinal OO.
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  • 文章类型: Case Reports
    骨样骨瘤是一种良性但疼痛的骨肿瘤,其治疗基于完全手术切除。我们在此通过文献综述报告一例年轻的桡骨上肢骨样骨瘤患者。
    Osteoid osteoma is a benign but painful bone tumor whose treatment is based on complete surgical resection. We here report the case of a young patient with osteoid osteoma of the upper extremity of the radius through a literature review.
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  • 文章类型: Journal Article
    目的:我们试图系统地评估和总结有关射频消融(RFA)治疗疼痛性脊柱骨样骨瘤(OO)的临床结果和并发症的现有文献。
    方法:PubMed,Scopus,和CENTRAL数据库按照PRISMA指南进行检索。包括关于脊柱OORFA后安全性和临床结果的可用数据的研究。
    结果:在14项纳入的研究中(11项回顾性研究;3项前瞻性研究),354例患者接受了脊柱OORFA。平均年龄为16.4至28岁(女性=31.3%)。病变直径介于3至20mm之间,在211/331(64%)患者的后部元件中经常见到。OO病变和神经元之间的平均距离在1.7和7.4mm之间。在12-24个月随访时,数字评定量表估计疼痛减轻为6.85/10(95%置信区间[95CI]4.67-9.04);在>24个月随访时(范围24-55个月)为7.29/10(95%CI6.67-7.91)。保护措施(例如,43/354(12.1%)患者使用硬膜外空气吹入或神经保护性无菌水输注)。在23/354(6.5%)患者中发现了局部肿瘤进展,然后成功地进行了RFA或开放手术切除。在4/354(1.1%)患者中报告了I-II级并发症,例如暂时性肢体感觉异常和伤口裂开。未报告III-V级并发症。
    结论:RFA在大多数患有疼痛性脊柱OO病变的患者中证明了安全性和临床有效性。然而,需要进一步的前瞻性研究来评估这些结局.
    OBJECTIVE: We sought to systematically assess and summarize the available literature on the clinical outcomes and complications following radiofrequency ablation (RFA) for painful spinal osteoid osteoma (OO).
    METHODS: PubMed, Scopus, and CENTRAL databases were searched in accordance with PRISMA guidelines. Studies with available data on safety and clinical outcomes following RFA for spinal OO were included.
    RESULTS: In the 14 included studies (11 retrospective; 3 prospective), 354 patients underwent RFA for spinal OO. The mean ages ranged from 16.4 to 28 years (Females = 31.3%). Lesion diameters ranged between 3 and 20 mm and were frequently seen in the posterior elements in 211/331 (64%) patients. The mean distance between OO lesions and neural elements ranged between 1.7 and 7.4 mm. The estimated pain reduction on the numerical rating scale was 6.85/10 (95% confidence intervals [95%CI] 4.67-9.04) at a 12-24-month follow-up; and 7.29/10 (95% CI 6.67-7.91) at a >24-month follow-up (range 24-55 months). Protective measures (e.g., epidural air insufflation or neuroprotective sterile water infusion) were used in 43/354 (12.1%) patients. Local tumor progression was seen in 23/354 (6.5%) patients who were then successfully re-treated with RFA or open surgical resection. Grade I-II complications such as temporary limb paresthesia and wound dehiscence were reported in 4/354 (1.1%) patients. No Grade III-V complications were reported.
    CONCLUSIONS: RFA demonstrated safety and clinical efficacy in most patients harboring painful spinal OO lesions. However, further prospective studies evaluating these outcomes are warranted.
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