Ina Sorge (Universitätsklinik Leipzig)  

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16 Years  

Male  

Neck-Bones  

neoplastic  

Increasing back pain for weeks, at night more than during the day, which led to increased insomnia. Paresthesia of the left hand.  

Osteoid Osteomas make up about 14% of all bone tumors, with the highest age frequency from 10 to 20 years. The often hypervascularized nidus causes a contrast uptake in MRI. The surrounding corticalis is usually asymmetrically thickened. A corresponding reaction of the surrounding soft tissue is common.
The vertebra are, after the proximal femur and tibia, the third most common localization. Boys are 3 times more often afflicted than girls. Nightly pain is typical. The proof of the nidus was, in our case, best found with CT.  

<- view MRI 1

MRI 1: T2-TSE sagittal: Hyperintense, round structure in the third cervical vertebra and the corresponding vertebral arch.



<- view MRI 2

MRI 2: T1-TSE sagittal: The same lesion is low-signal in T1.



<- view MRI 3

MRI 3: T1-TSE sagittal after contrast: The lesion in the 3rd cervical vetebra shows a noticeable enhancement.



<- view MRI 4

MRI 4: T1 KM transversal: Changes showing contrast uptake in the 3rd cervical vertebra on the left side, which extends to the vertebral arch. The vertebral arch is expanded on the left side.



<- view CT 1

CT 1: Osteolytic changes in the 3rd cervical vertebra. Asymmetric sclerosis of the 3rd cervical vertebra as well as the vertebral arch around the lesion.



<- view CT 2

CT 2: Lytic lesion in the vertebral arch of the 3rd cervical vertebra with sclerotic edges. The lesion compresses the left neruoforamen.



<- view CT 3

CT 3: Secondary reconstruction with visualization of the lesion in the left vertebral arch of the 3rd cervical vertebra.

 

Surgery / Histo  

Enchondroma
Osteochondroma
Osteoblastoma
Sclerotic osteomyelitis
Brodie Abscess
Malignant Tumors (without proof of origin) like Ewing or Osteosarcoma  

Treatment: Surgical with removal of the nidus.
Our patient is without symptoms or complaints since the operation.  

N/A  

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Osteoidosteoma, bone tumor, Osteoid osteoma, nightly back pain, nightly bone pain, vertebral, child, childhood, pediatric radiology  

Ina Sorge. Vertebral Osteoid Osteoma. PedRad [serial online] vol 4, no. 2.
URL: www.PedRad.info/?search=20040220080910