199
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Synovitis of the wrist joint caused by an intraarticular perforation of an osteoid osteoma of the scaphoid

      case-report

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Uncommon location and atypical presentation of the osteoid osteomas of the scaphoid can pose a diagnostic challenge. Because of its intraarticular location, scaphoid osteoid osteoma can present with synovitis which is the more commonly reported presentation for other intraarticular locations like in hip and elbow and only rarely reported at the wrist. We report a case of perforation of the osteoid osteoma into the wrist joint, resulting in exuberant synovitis. The clinical significance of this report is to reinforce that synovitis can be a presentation of osteoid osteoma and it should be considered in the differential diagnosis of monoarticular arthritis. Prolonged synovitis may cause damage to the other joint surfaces of the wrist and hence carpal osteoid osteoma should be considered for early surgical excision.

          Related collections

          Most cited references11

          • Record: found
          • Abstract: found
          • Article: not found

          Intraarticular osteoid osteoma associated with synovitis: a possible role of cyclooxygenase-2 expression by osteoblasts in the nidus.

          To clarify the condition of development of synovitis associated with intraarticular osteoid osteoma (OO), expressions of cyclooxygenase-2 (COX-2) protein and its messenger ribonucleic acid were investigated both in the nidus and the synovial tissue using immunohistochemical and reverse transcription-polymerase chain reaction analyses. Diffuse and strong COX-2 immunoreactivity was found in osteoblast-like tumor cells in the nidus of all six cases of OO (three of six cases were intraarticular OO associated with synovitis) and one case of osteoblastoma associated with synovitis. Expression of COX-2 messenger ribonucleic acid was demonstrated in one case of OO associated with synovitis, and was higher in the nidus than that in the inflamed synovial tissue. However, there were no significant difference between the nidus and synovium in the expression of cytosolic phospholipase A2, one of the enzymes involved in arachidonic acid metabolism, and inflammatory cytokines such as interleukin-1beta and tumor necrosis factor alpha. Finally, as there was only one case in which the examinations of gene expression were performed, no definitive overall conclusions could be reached; rather it is suggested that COX-2 expressed primarily by osteoblasts in the nidus of intraarticular OO may play a role in activating the pathway of arachidonic acid metabolism, resulting in synovitis of the involved joint.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Osteoid osteoma of the upper extremity.

            Forty-six patients with histologically confirmed osteoid osteoma of the upper extremity seen from 1947 to 1990 were retrospectively reviewed. The patients' age at presentation averaged 20 years. Twenty-four of the lesions were located in the wrist and hand and 22 in the arm and forearm. The average duration of symptoms before diagnosis was 15 months. Pain was the presenting symptom in 44 of 46 patients. Of the 28 patients who took aspirin for pain, 24 obtained at least partial relief. A mass or swelling was more commonly noted in lesions of the hand and wrist as compared to the arm and forearm. The diagnosis of osteoid osteoma was made by plain x-ray films alone in 35 cases. Bone scans were performed on 13 patients; all were positive at the site of the lesion. Tomography was performed in 13 cases to identify the intraosseous location of the lesion. All lesions were treated by excision and curettage. Thirty-four of the 46 patients were followed at our institution for more than 6 months, with an average follow-up period of 27 months. Six of the patients had persistent lesions. Of the six persistent osteoid osteomas, five occurred in the wrist or hand (p = .0012). A total of 15 procedures were required to excise these lesions.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Unusual presentation of osteoid osteoma of the scaphoid.

              The small carpal bones are infrequent sites for osteoid osteomas, and their clinical and imaging pictures may be quite confusing leading to suspect other etiologies. The authors present herein an unusual case of osteoid osteoma of the scaphoid superimposed on a wrist injury caused by a fall on the outstretched hand.
                Bookmark

                Author and article information

                Journal
                Indian J Orthop
                Indian J Orthop
                IJOrtho
                Indian Journal of Orthopaedics
                Medknow Publications & Media Pvt Ltd (India )
                0019-5413
                1998-3727
                Sep-Oct 2012
                : 46
                : 5
                : 599-601
                Affiliations
                [1]Department of Plastic Surgery, Hand Surgery, Reconstructive Microsurgery and Burns, Ganga Hospital, Coimbatore, India
                [1 ]Department of Pathology, PSG Institute of Medical Sciences and Research, Peelamedu, Coimbatore, India
                Author notes
                Address for correspondence: Dr. S Raja Sabapathy, Head, Department of Plastic Surgery, Hand Surgery, Reconstructive Microsurgery and Burns, Ganga Hospital, 313 Mettupalayam Road, Coimbatore – 641 043, India. E-mail: drpb12@ 123456yahoo.co.in
                Article
                IJOrtho-46-599
                10.4103/0019-5413.101051
                3491800
                23162159
                a2b50785-4246-44bc-a81f-5cd2eb47dcb1
                Copyright: © Indian Journal of Orthopaedics

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Categories
                Case Report

                Orthopedics
                synovitis wrist,scaphoid,osteoid osteoma,monoarticular arthritis,intraarticular location

                Comments

                Comment on this article