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    Case of the Day
    Osteoid osteoma of the tibia

    Modality: X-Ray Modality: CT Modality: CT Modality: MRI Modality: MRI

    View here all images of this case in different sizes !

    Go to the top of the page ID: 20021110232741
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     Osteoid osteoma of the tibia   
     Available images: There are X-Ray images available for this case. [ X-Ray ] There are X-Ray images available for this case. [ CT ] There are X-Ray images available for this case. [ MRI ]   

    Wolfgang Hirsch (Halle)  

     Email Address:

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    10 Years  




    10 year-old boy. For 3 months he complains of moderate pain in the lower leg region. Pain occurred in variable intensity during the day, but particularly at night. Treatment so far: immobilization.  

     Pathomorphology or Pathophysiology of this disease :

    Osteoid osteomas are, beside fibrotic cortical defects and osteomas, the third most frequent benign bone change of youth. It appears more frequently in boys than in girls. Usually, it is localized in the proximal femur, but it can also be frequently found in the tibia and in the spinal column. Also, all other bones (phalanges) can be afflicted. Nightly bone pain is typical as well as the prompt diminishing of pain when treated with aspirin.

    Centrally one finds the nest; the nest cavity is often hypervascularized. Surrounding reaction: Hyperostosis with often distinct asymmetrical cortical thickening.


     Radiological findings:

    X-ray 1 <- view X-ray 1

    X-ray 1: one-sided cortical thickening of the tibia. One circumscribed, lytic change cann not be proven in this x-ray image.

    MRI 1 <- view MRI 1

    MRI 1: T1 with fat saturation, transversal: in the dorsolateral area of the tibia within the cortical hyperostosis, a little, non-enhancing nidus and a border with contrast-uptake is seen.

    MRI 2 <- view MRI 2

    MRI 2: T2 with fat saturation: distinct bone edema and surrounding soft-tissue edema. Representation of the nidus.

    CT 1 <- view CT 1

    CT 1: transversal: representation of the nidus.

    CT 2 <- view CT 2

    CT 2: sagittal Reformation: representation of the nidus


     Diagnosis confirmation:

    Surgery / Histo  

     Which DD would be also possible with the radiological findings:

    No differential diagnoses if the nidus is obvious. Otherwise Ewing sarcoma, osteomyelitis, cortical irregularity syndrome  

     Course / Prognosis / Frequency / Other :

    Surgery is usually needed (after markings in CT). Other treatment approaches are being discussed.  

     Comments of the author about the case:


     First description / History:






     Most likely etiology:


     Available images: There are X-Ray images available for this case. [ X-Ray ] There are X-Ray images available for this case. [ CT ] There are X-Ray images available for this case. [ MRI ]   
    More cases from these authors: Search Wolfgang Hirsch in Medline Wolfgang Hirsch (17)     

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