Osteoid osteoma of the scaphoid bone associated with flexor carpi radialis calcific tendinitis and treated with CT-guided RF ablation.

Osteoid osteomas of the wrist are relatively rare and the diagnosis is challenging due to atypical clinical features. We describe a case of an osteoid osteoma of the scaphoid bone associated with calcific tendinitis of the adjacent flexor carpi radialis tendon and periarticular soft tissue calcifications in a 21-year-old man presenting with radial-sided wrist pain. The lesion was successfully treated with CT-guided RF ablation. To our knowledge, this is the first description of an osteoid osteoma of the wrist associated with calcific tendinitis and periarthritis. In addition, we discuss the technical details and difficulties of CT-guided RF ablation of scaphoid osteoid osteomas.

Spinal osteoid osteoma progressed to osteoblastoma with paraspinal soft tissue mass: a unique presentation.

Osteoid osteoma and osteoblastoma are rare benign bone-forming tumors with very similar histological features. They are nowadays considered as two distinct entities. Progression of an osteoid osteoma to osteoblastoma is considered very rare with only a few cases reported in the literature. Herein we describe a case of an osteoid osteoma of the thoracic spine in a 29-year-old woman that was initially treated conservatively and progressed to osteoblastoma 5 years following the initial diagnosis. Imaging revealed an increase in the size of the spinal lesion that was surrounded by extensive paraspinal abnormal soft tissue that raised suspicion for sarcomatous transformation. The final diagnosis was established by CT-guided biopsy of both the bone lesion and the paraspinal soft tissue, which excluded malignancy and revealed an osteoblastoma surrounded by plasma cell-rich chronic inflammation. The patient then underwent wide surgical excision of the lesion and paraspinal soft tissue component that confirmed the diagnosis. Follow-up with MRI over the next 12 months was unremarkable, with no signs of recurrence or spinal instability. This unique presentation of an osteoblastoma has not been previously described. This case also demonstrates the importance of follow-up of osteoid osteomas that are treated conservatively.

Defining a reference range of acetabular inclination and center-edge angle of the hip in asymptomatic individuals.

PURPOSE: Acetabular morphology is an important predictor of the severity of osteoarthrosis and survival of hip prostheses but there is limited data on the normal range of acetabular measurements on plain radiographs. The aim of this project was to determine the statistically normal ranges of acetabular inclination (AI) and center-edge angle (CEA). METHOD: One hundred coronal CT localizers (50 men and 50 women aged 20-30 years) were included in this study. All the patients underwent CT examination for thoracic or intra-abdominal indications. Patients with pelvic disease, fractures, history of serious trauma, or previous pelvic surgery were excluded. One pair of independent observers measured the AI and pelvic tilt (PT), and a further pair measured the center-edge angle (CEA), using electronic calipers on a high-resolution PACS workstation. RESULTS: AI and CEA measurements were obtained for 200 hips. There was very good intra-class correlation between the observers (r = 0.7-0.8). The mean AI was 38.8° (2SD 32.1-45.5°). That in men was 38.0° (2 SD 31.8-44.1°) and 39.6° (2 SD 32.7-46.8°) in women, which was statistically significantly different (p < 0.001). The mean CEA measurement for all patients was 36.3° (SD 13.8°), for men 37.7° (SD 10.8°) and for women 34.9° (SD 11.4°) with a statistically significant gender difference (p < 0.001). The mean pelvic tilt measurement (sacro-coccygeal-pubic symphysis) was 38.3 mm (2 SD 18.3-58.3 mm) with a significant gender difference (p < 0.001). CONCLUSIONS: The results of this study define reference ranges of two common measures of acetabular morphology and confirm statistically significant differences between men and women.

Varicosities in an adolescent girl on laparoscopy: an unusual presentation of May-Thurner syndrome.

May-Thurner syndrome is a rare clinical entity involving venous obstruction of the left lower extremity. May-Thurner syndrome most commonly presents with deep vein thrombosis. We describe an unusual presentation of a girl with a dragging abdominal pain mimicking the symptoms of a varicocele. Diagnosis can be made with MR venogram. There are many different treatment options but if compression of the vein is minimal conservative management is possible.