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Osteoid Osteoma - Everything You Need To Know - Dr. Nabil Ebraheim
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- Опубліковано 31 жов 2018
- Dr. Ebraheim’s educational animated video describes the condition of Osteoid Osteoma.
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Osteoid osteoma is a benign, bone forming neoplasm. It has a small nidus of neoplastic tissue surrounded by a heavy zone of reactive mature bone. It is usually located intracortically within the diaphysis of long bones. The proximal femur around the area of the lesser trochanter is a favorite location. The femur and tibia are the most common locations for Osteoid Osteoma to occur in addition to the posterior elements of the spine. It affects the posterior elements of the spine, for example the pedicles or the lamina. Osteoid osteoma is the most common benign tumor of the carpal bones. Osteoid osteoma affects males more than females. 70% of the patients are younger than 20 years old. Osteoid osteoma can look like a stress fracture. If the lesion has large bone reaction, rule out stress fracture. A stress fracture produces more linear radiolucency. With osteoid osteoma, you will have a central lucent nidus area surrounded by a sclerotic area. The nidus is oval or round, and it is well demarcated. The nidus is the lytic lesion. The diameter of the nidus is usually less than 1.5cm. The nidus has a self-limited growth. The osteoid osteoma usually becomes asymptomatic and spontaneously heals. CT scan and MRI will show the lesion as well circumscribed and a cortically based lesion with significant surrounding edema. You will find increased uptake (hot bone scan). Osteoid osteoma is a painful condition that is worse at night and no history of trauma. The painful symptoms are mediated by Prostaglandin E2. There will be increased Cyclooxygenase (COX) activity, which is why the lesion is relieved by aspirin and anti-inflammatory drugs. A differential diagnosis is a Brodie’s Abscess. Osteoid osteoma is located within the cortex. The Brodie’s abscess is located within the medullary canal or in the cancellous bone. The chronic abscess may be surrounded with fibrous tissue and sclerotic bone. It may be difficult to differentiate the Brodie’s abscess from the osteoid osteoma. Other differential diagnoses include osteosarcoma and osteoblastoma. The pathology will show very cellular and vascular stroma with plump, but not atypical osteoblast cells, making a matrix of immature woven bone. The heavy, mature reactive trabeculae encircles the nidus. There will be no inflammatory cells or dead bone to suggest Brodie’s abscess or osteomyelitis. There will be demarcation between the nidus and the bone, and the woven bone will have rimming osteoblasts. Osteoid osteoma is the most common cause of painful scoliosis in young patients. The curvature of the scoliosis is concave towards the site of the lesion. With osteoid osteoma of the thoracic spine, the level of the lesion corresponds to the level of the apex of the resulting scoliosis in the thoracic spine. With osteoid osteoma of the lumbar spine, in the lower lumbar region, the apex of the scoliosis may be above the lesion. Surgical excision of the lesion can help the scoliosis, except if the curvature is large or if excision is delayed in younger patients. The most important step in the treatment will be observation and oral anti-inflammatory medications. This is followed by CT guided radiofrequency ablation if the conservative treatment fails. Radiofrequency ablation (RFA) is usually done in the majority of cases that are painful, except in the spine, because of the proximity to the dura and to the nerve roots, and don’t use RFA in the hand. We don’t use RFA in the digits because of the thermal necrosis of the overlying skin and due to the proximity of the neurovascular structures. The treatment is surgical resection with curettage in the spine and in the digits.
this was actually very helpful. thank you for such clarifying information
Thank you! This is the most information I have seen on these tumors.
Thanks for your nice and benefite knowledge
Doc, always learning from you. Thanks for the video.
Same like u,..his videos r helpful,..
Excellent lecture
Please make video on scoliosis, classification, diagnosis (case presentation)and treatment
Yrs. It was very helpful! Thank you!!
Very helpful Professor
excellent sir
Interesting material
Thank you so much
Very well explained thank u
amazing
Thanks sir
thanks for the transcript.
Thanks
I have it too now and its super painfull you cant sleep without taking pills
@perlla I hope you get well soon
I have too
How many months did u take painkillers and how it diagnosis?
@@kissandost1m741hi I have too and I’ve been taking obsessively painkillers since april 2023 and still the pain grows. i had my diagnosis in october and my surgery after ten days
I had this done on march 16th 2018 and god it was painful!
How old were you when you had to get it
Can you tell me if we make operation did the tumor will return again?
I had osteoid osteoma surgery 2 days back in the femur bone same location that shown in the video
How many months did u take painkillers?
I had the lesion in neck of the femorand done surgery 4 years back with 4years of pain. It get worse like i had AVN WITH Osteoid osteoma.
Which procedure is done to you.
Thankyou I been having a bump on my forehead not noticeable but often get the odd pains at night just doing research on it
Hi who is the best Dr in India for this treatment?
I need a help for this sittuation
I Had a surgery 2 days ago after 7 months of pain... Thank god it's over!
How r u now?pls give hospital name and Dr name?
Plzz tell me that what treatment
This is my problem
Did you relived from pain now?
Please, help. I've had osteoid osteoma on femur removed back in 2013 ; and now im feelin symptoms again, which is night leg pain. Is it possible it recurred? Im fucking pissed off...
Yes see your doctor. I just had an occurrence in my right knee cap and had surgery on 4/27/2021 and I am being checked again in September to make sure it does not grow back. Have you gone to your doctor for an x-ray? Praying all is ok with you! 🙏🏻🙏🏻🙏🏻 I never suffered with such intense pain in my entire life as I did having this! God bless you!
@@workfromhome411_ Thanks for answering. Pain has passed away fortunately, since I also have Chiari malformation and those 2 are connected it could've caused me pain as well.
@@zarkoostojic9063 I am so happy your pain has stopped! Nothing worse then that kind of pain! Pray you have full body healing 🙏🏻🙏🏻🙏🏻
@zarkoostojic9063 please tell which location u got pain exactly?
after cured osteiod osteoma is there any future problem to the patient.
I had this and the only problems I have is that I can't stretch my leg that well.
Zombsroyale TEDDY hi where was the location at the ankle or knee?
Is it a disease
Nope
Mild loss of lumber lordosis .xray report one video
:)
इस का इलाज कहा होता है फोन नंबर डाक्टर दो
Aap apne do
Sir please halp me
Thanks