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Osteoid osteomas of the hip: a well-recognized entity with a proclivity for misdiagnosis.
Wenger, Doris E; Tibbo, Meagan E; Hadley, Matthew L; Sierra, Rafael J; Welch, Timothy J.
Afiliação
  • Wenger DE; Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN, USA. wenger.doris@mayo.edu.
  • Tibbo ME; Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, USA. wenger.doris@mayo.edu.
  • Hadley ML; Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, USA.
  • Sierra RJ; Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, USA.
  • Welch TJ; Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, USA.
Eur Radiol ; 33(11): 8343-8352, 2023 Nov.
Article em En | MEDLINE | ID: mdl-37284866
OBJECTIVES: The diagnosis of osteoid osteomas (OO) about the hip can be challenging as presenting symptoms can mimic other, more common, periarticular pathologies. Our aims were to identify the most common misdiagnoses and treatments, mean delay in diagnosis, characteristic imaging features and provide tips for avoiding diagnostic imaging pitfalls for patients with OO of the hip. METHODS: We identified 33 patients (34 tumors) with OO about the hip who were referred for radiofrequency ablation between 1998 and 2020. Imaging studies reviewed included radiographs (n = 29), CT (n = 34), and MRI (n = 26). RESULTS: The most common initial diagnoses were femoral neck stress fracture (n = 8), femoroacetabular impingement (FAI) (n = 7), and malignant tumor or infection (n = 4). The mean time from symptom onset to diagnosis of OO was 15 months (range, 0.4-84). The mean time from initial incorrect diagnosis to OO diagnosis was 9 months (range, 0-46). CONCLUSIONS: The diagnosis of OO of the hip is challenging, with up to 70% of cases initially misdiagnosed as a femoral neck stress fracture, FAI, bone tumor, or other joint pathology in our series. Consideration of OO in the differential diagnosis of hip pain in adolescent patients and awareness of the characteristic imaging findings are critical for making an accurate diagnosis. KEY POINTS: • The diagnosis of osteoid osteoma of the hip can be challenging, as demonstrated by long delays in time to initial diagnosis and high rates of misdiagnoses which can lead to inappropriate interventions. • Familiarity with the spectrum of imaging features of OO, especially on MRI, is imperative given the increase in the utilization of this modality for the evaluation of young patients with hip pain and FAI. • Consideration of OO in the differential diagnosis of hip pain in adolescent patients and awareness of the characteristic imaging findings, including bone marrow edema and the utility of CT, are critical for making a timely and accurate diagnosis.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Osteoma Osteoide / Neoplasias Ósseas / Fraturas de Estresse / Fraturas do Colo Femoral / Impacto Femoroacetabular Tipo de estudo: Prognostic_studies Limite: Adolescent / Humans Idioma: En Revista: Eur Radiol Assunto da revista: RADIOLOGIA Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Osteoma Osteoide / Neoplasias Ósseas / Fraturas de Estresse / Fraturas do Colo Femoral / Impacto Femoroacetabular Tipo de estudo: Prognostic_studies Limite: Adolescent / Humans Idioma: En Revista: Eur Radiol Assunto da revista: RADIOLOGIA Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Estados Unidos