A 10-year-old boy with right leg pain

 

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Doctor's Information

Name : Maryam
Family :Noori
Affiliation : ----------------
Academic Degree: ----------------
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Resident : ----------------

 

Patient's Information

Gender : Male
Age : 10

 

Case Section

Muskuloskeletal System

 

Clinical Summary

A 10-year-old boy with right leg pain.

 

 

Imaging Procedures and Findings

A 10 year old boy complained about localized pain at medioproximal part of his right leg. On plain x ray, cortical thickening is noted at medial meta-diaphysis of tibia. On performed CT scan, a small lytic lesion with surrounded sclerotic changes & foci of calcifications within it is depicted. Performed MRI revealed extensive bone marrow edema on T2 fat sat sequences. Bone scan shows double density sign.

 

Discussion

Osteomyelitis regardless of appearance of nidus resembles osteoid osteoma. Enostosis (Bone Island), has no increased activity on bone scan. It has thorny radiations & is low signal on T2WI MR. Stress Fracture: has radiolucency more linear and perpendicular to cortex (rather than parallel). Osteoblastoma is larger (> 2-2.5 cm) than osteoid osteoma & has a progressive pattern with no regression. Osteoma is cold on bone scan with no periosteal reaction & no nidus.

 

Final Diagnosis

Osteoid Osteoma

 

References

Diagnostic Imaging Orthopedics, David W. Stoller. MD. FACR, Phillip F.J. Tirman. MD, Miriam A. Bredella. MD, et al. Fundamental of diagnostic radiology, William E. Brant, Clyde A. Helms.

 

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