Intra- and Juxta-Articular Osteoid Osteoma Mimicking Arthritis: Case Series and Literature Review

Intra- and juxta-articular osteoid osteomas are rare, representing less than 10% of all osteomas. Compared to the classic diaphyseal or metaphyseal site of long bones, they often have an atypical onset, a longest diagnostic delay, and frequent initial misdiagnoses, with pictures that can mimic infla...

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Bibliographic Details
Published in:Children (Basel) 2023-05, Vol.10 (5), p.829
Main Authors: Civino, Adele, Diomeda, Federico, Giordano, Luca, Damasio, Maria Beatrice, Perrone, Sandra, Gallizzi, Romina, Ravelli, Angelo, Piscitelli, Prisco, Maggio, Maria Cristina
Format: Article
Language:English
Subjects:
Arthritis
Bone cancer
child
Comparative analysis
Histology
joint pain
juvenile idiopathic arthritis
Literature reviews
Medical diagnosis
Medical imaging
Nonsteroidal anti-inflammatory drugs
osteoid osteoma
Pain
Pediatrics
Rheumatology
Steroids
synovitis
Trauma
Young adults
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Summary:Intra- and juxta-articular osteoid osteomas are rare, representing less than 10% of all osteomas. Compared to the classic diaphyseal or metaphyseal site of long bones, they often have an atypical onset, a longest diagnostic delay, and frequent initial misdiagnoses, with pictures that can mimic inflammatory monoarthritis. We aimed to describe a case series, and to provide a literature review of this uncommon and misleading tumor location. We performed a retrospective analysis of patients referred to three pediatric rheumatology centers, with a final diagnosis of articular osteoid osteoma. A review of the literature was additionally conducted. We included 10 patients with a mean age of 14 years. All patients with unusual sites (olecranon fossa, lumbar vertebra, distal phalanx of the toe, fibula) had a misdiagnosis, and cases with initial suspicion of monoarthritis had the longest diagnostic delay, up to 24 months. The literature review confirms the significant risk of misdiagnosis, and an average time from symptom onset to diagnosis ranging from 0.4 to 1.8 years. Articular osteoid osteoma may mimic arthritis, especially in adolescence. Knowledge of the atypical forms of presentation, and of the clinical and radiological pitfalls, reduces the risk of diagnostic error.
ISSN:2227-9067
2227-9067
DOI:10.3390/children10050829