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Case Reports
. 2017:2017:5846368.
doi: 10.1155/2017/5846368. Epub 2017 May 2.

Intra-Articular Osteoid Osteoma as a Cause of Anteromedial Knee Pain

Ergin Sagtas  1 , Kemal Gokkus  2 , Ahmet Turan Aydin  2
Affiliations
Case Reports

Intra-Articular Osteoid Osteoma as a Cause of Anteromedial Knee Pain

Ergin Sagtas et al. Case Rep Orthop. 2017.

Abstract

A 32-year-old male patient presented to our clinic with chronic left knee pain that was ongoing for about 1.5 years. The patient visited several times our clinic and the other clinics; conservative treatment (including rest, knee brace, and ice application with NSAIDs) was recommended by various different doctors. The anamnesis, physical examination, and plain radiography were nonspecific. Early MRI findings mislead us to believe it is bone marrow edema. One and half years with noneffective treatment, the knee pain persisted. At the latest visit intra-articular osteoid osteoma was suspected and the knee MRI with CT was employed. Even though the diagnosis of intra-articular osteoid osteoma often presents a challenge for the surgeons, with a present awareness of intra-articular osteoid osteomas which lack the characteristic sclerotic lesions and nidus on plain X-rays and the aid of multislice CT, a correct diagnosis which warrants proper treatment can be achieved. The possibility of osteoid osteomas, especially in young adults with persistent knee pain with unknown reasons that show normal plain radiographs results, must not be overlooked. The treatment method of these lesions should be customized depending on the location of the lesion, experience of the surgeon, and cost of method.

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Figures

Figure 1
Figure 1
Normal findings at plain radiography.
Figure 2
Figure 2
T2 weighted images (a and c) showed the hypointense lesion (yellow arrow) located at tibia anteromedial plateau with ill-defined bone marrow edema; (b) T1 weighted image showed the well-defined bordered hypointense lesion (yellow arrow).
Figure 3
Figure 3
Coronal (a), axial (b), and sagittal (c) CT images showed the perinidal sclerosis with centrally calcified nidus (yellow arrow) consistent with an osteoid osteoma.
Figure 4
Figure 4
Intraoperative photo that shows surface discoloration over the lesion.
Figure 5
Figure 5
Photomicrograph of the lesion revealing abundant osteoid formation characteristic of an osteoid osteoma [H&E, ×4 obj. (a), ×10 obj. (b)].
See this image and copyright information in PMC

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