PMC8113715_01
Osteoid osteoma in a 14-year-old male patient.. A. Anteroposterior view of the left wrist, B. Computed tomography (CT) shows an 8-mm-sized radiolucent lesion with central dense radiopacity in the distal radius (arrows), near the epiphyseal plate (arrow heads).
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Left wrist radiograph and computed tomography (CT) showed an 8-mm radiolucent lesion with central dense radiopacity and adjacent eccentric minimal sclerosis in the distal radius, near the epiphyseal plate (Fig. 1).
Magnetic resonance imaging (MRI) of the left wrist.. A. Axial, B. Coronal fat-suppressed T2-weighted image shows a central iso- to hypointense lesion with thin hyperintense peripheral rim (arrows) in the epiphysis of the distal radius. Poorly defined perilesional hyperintensity (arrowheads) suggesting bone marrow edema was also noted.. C. Axial, D. Coronal T1-weighted image reveals intermediate intense central nidus (arrows) with hypointense margin (arrow heads).. E. Axial, F. Coronal gadolinium-enhanced fat-suppressed T1-weighted image shows peripheral rim enhancement (arrows) as shown in high-intensity signal on T2-weighted image. The nidus shows diffuse mild to moderate enhancement (arrow heads).
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Moreover, a prominent bone marrow edema involving the epiphysis and metaphysis of the left distal radius was observed (Fig. 2).
Whole-body bone scintigram shows focal increased tracer uptake (arrow) in the left distal radius, and physiologic tracer uptake in both physeal plate considered as normal finding in young age was shown.
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Bone scintigram demonstrated focal increased tracer uptake in the lesion, and physiologic tracer uptake in the physeal plate was also noted (Fig. 3).
Histologic specimen of the osteoid osteoma.. The central nidus of the lesion shows interconnected, delicate trabeculae of woven bone (arrow). Moreover, the trabeculae were thin and lined by osteoblasts, growing within the highly vascularized connective tissues without evidence of inflammation.
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Thus, the lesion was diagnosed as epiphyseal intramedullary osteoid osteoma (Fig. 4).