Cause analysis of misdiagnosis of lesser trochanter osteoidosteoma as chronic osteomyelitis
10.3969/j.issn.1002-1671.2018.03.022
- VernacularTitle:小转子处骨样骨瘤误诊为慢性骨髓炎的原因分析
- Author:
Zhiwei HAN
1
;
Jingji XU
;
Jinsong ZHANG
;
Mengqi WEI
;
Hong YIN
Author Information
1. 空军军医大学西京医院放射科
- Keywords:
osteoidosteoma;
osteomyelitis;
computed tomography;
magnetic resonance imaging
- From:
Journal of Practical Radiology
2018;34(3):408-410
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the clinical features and imaging findings of lesser trochanter osteoidosteoma,and to discuss the causes of its misdiagnosis as chronic osteomyelitis.Methods The clinical features,X-ray,CT and MRI findings of 6 cases with pathologically confirmed osteoidosteoma in the lesser trochanter were reviewed retrospectively.Symptoms included knee pain (1 case),thigh pain (4 cases)and hip joint pain(1 case);claudication(2 cases),and night pain(1 case).Five patients had right-side,and 1 patient had left-side involvement.All the 6 cases were misdiagnosed as chronic osteomyelitis before operation.Results Four patients had CT scan,which showed intra-cortical niduses at the lesser trochanters with peri-focal sclerosis,joint capsule swelling and joint effusion. Five patients had MRI exams,MR images showed bone marrow edema,synovial thickening,joint capsule swelling and joint effusion in all the 5 cases,but only 2 showed niduses.Six patients had X-ray imaging exams,X-ray images showed bone sclerosis without radiolucent nidus.Conclusion Osteoidosteoma in the lesser trochanter may display atypical clinical features that might be difficult to be differentiated from chronic osteomyelitis without sufficient examination.CT is best in showing niduses,except some niduses with atypical shape,superficial location and high-density calcification.MRI-T2WI is sensitive in showing the inflammation and bone marrow edema with high signal intensity,which may affect nidus displaying.X-ray images can only display bone sclerosis without niduses.
