PMC3504221_01
Preoperative X-ray showing local lucent nidus at the left proximal fibula.
CRIM.ORTHOPEDICS2011-324650.001.jpg
PMC3504221_01_CRIM.ORTHOPEDICS2011-324650.001.jpg
fig1
In the first radiographs, a local lucent nidus at the left proximal lateral fibula was seen (Figure 1).
T1-weighted MRI scan showing the nidus surrounded by hyperintense tissue.
CRIM.ORTHOPEDICS2011-324650.002.jpg
PMC3504221_01_CRIM.ORTHOPEDICS2011-324650.002.jpg
fig2
The diagnosis of osteoid osteoma was confirmed with an MRI scan (Figure 2).
(a) The patient marked the most painful side distal to the fibular head. (b) The common peroneal nerve is in anatomical proximity to the tumor location.
CRIM.ORTHOPEDICS2011-324650.003.jpg
PMC3504221_01_CRIM.ORTHOPEDICS2011-324650.003.jpg
fig3
The patient marked her skin at the point of maximum pain (Figure 3(a)), and the incision was made at this location. After identifying the proximal portion of the common peroneal nerve at the posterior border of the short head of the biceps femoris, the nerve was retracted and dissection was performed along the course of the nerve in a distal direction (Figure 3(b)).
Histologically, a nidus of osteoid osteoma (left side) is seen bordered by sclerotic bone (right side). Bar: 100 mum.
CRIM.ORTHOPEDICS2011-324650.004.jpg
PMC3504221_01_CRIM.ORTHOPEDICS2011-324650.004.jpg
fig4
Bone trabeculae were surrounded by numerous activated osteoblasts without cytologic atypia (Figure 4).
Postoperative radiographs demonstrate the resection zone of one-third of the shaft's width.
CRIM.ORTHOPEDICS2011-324650.005.jpg
PMC3504221_01_CRIM.ORTHOPEDICS2011-324650.005.jpg
fig5
Radiographs showed complete removal of the osteoid osteoma, including the nidus, with a resulting lesion the size of one-third of the shaft width (Figure 5).