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Osteoid osteomas: a pain in the night diagnosis

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Abstract

Osteoid osteoma is a common benign bone-forming lesion that is composed of a nidus of vascular osteoid tissue and woven bone lined by osteoblasts. It is frequently associated with considerable surrounding inflammation. The diagnosis is usually straightforward when imaging reveals a radiolucent nidus surrounded by variable degrees of reactive sclerosis. However, the diagnosis can be elusive when osteoid osteomas occur in atypical locations, as they may have a nonspecific and misleading appearance on different imaging modalities, particularly on MRI. The purpose of this pictorial essay is to review the typical and atypical features of osteoid osteomas on different imaging modalities, and the appearance of osteoid osteomas in different locations. We also review growth disturbances caused by osteoid osteomas and potential mimickers, with imaging characteristics that can aid in diagnosis.

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Acknowledgements

This work was awarded an honorable mention as an educational poster at SPR 2012, San Francisco, CA.

We thank Dr. Anne Marie Cahill from the Department of Radiology and Dr. John Dormans from the Department of Orthopedics at the Children’s Hospital of Philadelphia for their help and contributions to this manuscript.

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Authors and Affiliations

  1. Department of Radiology, The Children’s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, 34th St. and Civic Center Blvd., Philadelphia, PA, 19104, USA

    Nancy Laurence, Monica Epelman, Richard I. Markowitz, Camilo Jaimes, Diego Jaramillo & Nancy A. Chauvin

  2. Department of Radiology, Nemours Children’s Hospital, 13535 Nemours Parkway, Orlando, FL, 32827, USA

    Monica Epelman

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  1. Nancy Laurence
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  2. Monica Epelman
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  3. Richard I. Markowitz
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  4. Camilo Jaimes
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  5. Diego Jaramillo
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  6. Nancy A. Chauvin
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Correspondence to Nancy A. Chauvin.

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Laurence, N., Epelman, M., Markowitz, R.I. et al. Osteoid osteomas: a pain in the night diagnosis. Pediatr Radiol 42, 1490–1501 (2012). https://doi.org/10.1007/s00247-012-2495-y

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  • DOI: https://doi.org/10.1007/s00247-012-2495-y

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