Juxtaarticular Osteoid Osteoma
Osteoid osteomas located within the articular capsule are rare . Elbow, hip, and ankle joints are most commonly involved.
Juxtaarticular Osteoid Osteomas are typically associated with nonspecific symptoms similar to other common joint disorders.
Pain is usually less intense when compard to osteoid osteomas of other region, and its response to nonsteroidal anti-inflammatory drugs is less dramatic. The intraarticular nidus is difficult to identify, and there is no periosteal reaction. Consequently, there is usually a considerable delay between the onset of symptoms and identification of the nidus.
Bone scintigraphy, computed tomography, and magnetic resonance imaging are essential for early detection of the nidus. In addition, these techniques usually reveal minimal periosteal reaction and sclerosis at a distance from the lesion on either side of the joint.
The absence of distinct sclerosis around these lesions is probably related to a lack of functional periosteum.
Intraarticular osteoid osteoma can provoke periarticular osteoporosis similar to that associated with inflammatory arthropathy.
Intraarticular lesions may even induce degenerative changes within the articular cartilage, promote proliferation of chondrocytes with angiogenesis, and promote migration of mesenchymal cells in the subchondral bone.
These changes are responsible for the development of secondary osteoarthritis with osteophyte formation and occasionally extensive joint destruction.
Osteoid osteoma may induce premature fusion of the epiphysis in rare cases.
Synovium is generally edematous, thickened and shows villous overgrowth. It is characterized by a lymphoproliferative synovitis with multiple lymphoid follicles indistinguishable from rheumatoid arthritis.
Synovial changes spontaneously subside after removal of the nidus.
Subperiosteal Osteoid Osteoma
Subperiosteal osteoid osteoma is a relatively rare lesion. Conventional radiographs demonstrate a lucent lesion on the surface of bone with adjacent periosteal reaction.
The nidus is typically radiolucent with no evidence of central opacity.
This osteoid oseoma is larger in size due to the absence of restricting compressive force on side of periosteum. This lesion possses histologic features of surface lesions. The subperiosteal nidi are on average less sclerotic and have thinner trabeculae and a greater proportion of stromal tissue compared with intracortical lesions.
Popularity: 1% [?]
Related posts:
About Dr Arun Pal Singh
