PMC6159126_01
(a) Initial radiograph (posteroanterior film) 12 years previously shows an oblique fracture at the mid-diaphysis of both radius and ulna. (b) Postoperative anteroposterior film depicting intramedullary pinning and beginning signs of callus formation. The radius demonstrates nearly complete bony bridging. The ulna shows partial but incomplete bony bridging.
bjrcr.20150141.g001.jpg
PMC6159126_01_bjrcr.20150141.g001.jpg
f1
Previous medical history included a fracture of both radius and ulna 12 years previously, which had been successfully treated with reduction and by intramedullary pinning (Figure 1).
Anteroposterior (a) and lateral (b) plain radiographs at current admission reveal a focal intracortical lucency (white arrow) adjacent to the previous fracture site with surrounding sclerosis and cortical thickening (white arrowheads).
bjrcr.20150141.g002.jpg
PMC6159126_01_bjrcr.20150141.g002.jpg
f2
Conventional radiographs of the left forearm revealed a lucent area adjacent to the previous fracture site with surrounding sclerosis and cortical thickening (Figure 2).
(a) Coronal T1 weighted image. (b) Coronal T2 weighted image. (c) Axial T2 weighted image. (d) Axial fat-suppressed T1 weighted image after administration of gadolinium contrast. (e) Axial subtraction of the images before and after gadolinium contrast administration. MRI shows a focal intracortical lesion in the ulna with low central signal intensity and mineralization on both T1 and T2 weighted images (white arrows). After administration of gadolinium contrast, there is marked peripheral enhancement of the lesion with perilesional bone marrow and soft-tissue oedema (white arrowheads).
bjrcr.20150141.g003.jpg
PMC6159126_01_bjrcr.20150141.g003.jpg
f3
After administration of gadolinium contrast, there was marked peripheral enhancement of the lesion with perilesional bone marrow and soft-tissue oedema (Figure 3).
(a) Axial CT image. (b) Coronal reformatted CT image. CT visualization of a cortical nidus in the ulna, suggestive of an osteoid osteoma.
bjrcr.20150141.g004.jpg
PMC6159126_01_bjrcr.20150141.g004.jpg
f4
Because imaging characteristics were highly suggestive of an OO, an additional CT scan was performed (Figure 4).