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322

Osteoid S. Mitnick,1

Julie and

Nancy

B.

Osteoid which

Philip

uptake

been

with

is

a

well

described

bone

regionally

Unusual

known

as

benign

producing

We

evaluation.

scan

in

addition

increased

bone

an

joint

tumor,

intense

widening

bulging

posterior

report a patient in a diffuse low level

showed

showed

some

localized

at the and

was

in

the

left

become

first

hip

for

him

to seek

Hospital

with

The

in

the

3

during

and

weight

examination

was

weeks

bearing

by

Radiography

(fig.

proximal

There

was

a well

defined

1 A) demonstrated

femur,

The

internal

re-

pain

the

Osteoid

was

rotation.

as were

marked

thickening

8 mm

an

margins

the

of the

lucency

within

area

of which cortex the

The

laboratory

of sclerosis

were

poorly

medially

and

sclerotic

region.

in the there

The

[1

entity

are

Olson

[2] first

of

[3]

defined.

diaphysis

consistent not

showed

lesion

with

obtained

proximal

in radioactivity was

minimal performed

a vascular

for

osteoid

histologic

study.

is a common

limited

in the

scaphoid childhood

of

in a patient osteoid

with

an

tibia.

uptake

osteoid

osteomas,

increased

distal

increased

osteoma.

it was

bone of

McCombs

markedly in the

localized

benign

evaluation

literature.

localized osteoma

described

isotopic

radiologic

reported

demonstrated

hip

well

reports

noted

this

and uptake

Bohne in the

et al. carpal

In a report that

in five

extra-

camera

image

of

B Fig

1 -A. Diffuse

Received

Radiolucent low

level

nidus increased

December

All authors: AJR

was

However,

].

18F in an osteoid

was

left

osteoma

tumor

A

hips

were

tissue

increase

of the

increased to

Discussion

values. medial

of the

level

and

examination

normal,

had

admission,

Physical on

rest

low

epiphyseal

a specific

resection

findings

Synovial

the

and mento-

pain

aspirin,

to palpation.

and

The

right

diffuse from

with

superiorly,

A

a previously

intermittent

before

pain

otherwise

and

unrelieved

attention.

thigh

for

of a limp

pain,

medical left

admission

a history

year.

of the

marked

physical

1

severe

swelling

more

Bellevue

boy

more

prompted vealed

the

1 4-year-old

femur

Surgical

pathologic

narrowing

laterally.

extending

lesion.

activity.

osteoma. This

hip

of the

of the

slight

planes

1 B) demonstrated

left

part

site

tissue

(fig.

the

in

diaphyseal

activity.

Report

healthy

Appearance

medially,

of soft

scan

activity

increased

Case

Isotopic

BraunStein,

scintigraphic

the

of the Hip:

Genieser

osteoma

has

whom of

Osteoma

1 33:322-323,

4, 1978;

Department

August

surrounded activity

accepted

of Radiology,

1 979;

by zone from

left

after

revision

New

036 1 -‘803X

of sclerosis

femoral

York

/

79

March

University

.

in left

epiphysis

1 332-0322

proximal

extending

28,

femur.

Widening

to proximal

of joint

diaphysis.

space

Intensely

medially increased

(arrow). activity

B. Gamma at site

of lesion

(arrows).

1979.

Medical $00.00:

Center,

550

American

Fist

Ave.,

Roentgen

New Ray

York, Society

NY

10016.

Address

reprint

requests

to J. S. Mitnick.

of

AJR:133,

August

spinal

lesions

with

unusual

clinical

findings,

strated intense localized uptake [4]. In fact, some have recommended

of

plain

bone

radiographic

formed

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CASE

1979

positive The

pain,

area searching findings in our

hip were

unusual

was

confined

not

uptake,

but

extending present, osteoma. osteoid joint

abnormality,

for unexplained

in that

was from

scanning

for occult osteoid patient with osteoid

osteoma. osteoma

appearance region

femoral

be

by tomography

the isotopic

the

familiarize

Increased epiphysis

of

space.

Pathologic

examination

a lymphofollicular

sions.

Our

patient

superiorly

and

soft tissue

planes.

widening

of the

We thank aration.

case

activity

diffusely

diaphysis

reactive

secondary

narrowing

medially,

We believe

uptake in our case may vasculanity of the lesion, and

synovitis

showed

of

along

that the pattern

have resulted coupled with

hyperemia.

with

This

bulging

of the

of increased

is described

2.

4.

5,

to

.

Winter

variation when

of

the

located

isotopic in

the

Barbara

Lombardo

for assistance

in manuscript

prep-

6.

PF,

Johnson

PM,

Hilal

5K,

Feldman

F:

Scintigraphic

Radiology 1 22 : 1 77-1 78, 1977 McCoombs RK, Olson WH: Positive ‘8F bone scan in a case of osteoid osteoma: case report. J NucI Med 1 6 : 465-466, 1975 Bohne WH, Levine DB, Lyden JP: ‘8F scintimetnic diagnosis of osteoid osteoma ofthe carpal scaphoid bone. Clin Orthop 107: 156-158, 1975 Gilday OH: Diagnosis of obscure childhood osteoid osteomas with the bone scan (abstr). J Nuc! Med 1 6 : 465-644, 1975 Snarr JQ, Abell MR, Martel W: Lymphofollicular synovitis with osteoid osteoma. Radiology 1 06 : 557-560, 1973 Tachdjian MO: Pediatric Orthopedics, Philadelphia, Saunders, 1972, p387 detection

be-

space

from the intrinsic an associated syn-

patient

1

3,

demon-

joint

this osteoma

REFERENCES

was

to these

the

osteoid

of a joint.

ACKNOWLEDGMENT

increased

series

with

an

per-

in this

in his

region

of

of the

of

to the

radiologists

appearance

with intense activity at the site of the osteoid Snarr et al. [5] reported five cases of intraarticular osteomas associated with uniform narrowing of the

strated

ovitis

followed

diffuse.

demon-

99mTc diphosphonate that in the absence

to a circumscribed more

all

323

REPORTS

of osteoid

osteoma.