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MEDICINA E CHIRURGIA DELLA CAVIGLIA E DEL PIEDE

A Journal on Physiopathology and Surgery of the Foot


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Chirurgia Del Piede 2003 September;27(3):107-14

language: Italian

Paraosteal osteoid osteomas of the foot. Casistic review

Pisani P. C., Milano L.


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The diagnostic, clinical and instrumental features of a personal series of 6 subperiosteal and 3 subchondral osteoid osteomas of the tibiotalar region, the neck of the talus and the distal end of the tibia are described and documented. Subchondral forms are relatively rare by comparison with intra- and subcortical osteomas. The diagnosis of both subperiosteal osteoma at the neck of the talus and subchondral forms at the border of the tibia or the trochlea is often rendered difficult by a symptomatology and progression that resemble the sequelae of a post-traumatic inflammatory arthropathy. Patients, too, are commonly young athletes particularly prone to ankle injuries, even in amateur sports. The existence of a trauma in the prior history, in fact, encourages both instrumental examinations incapable of leading to a correct diagnosis, and ineffective forms of treatment, whereas insufficient weight is attached to the typical, often nocturnal pain of osteoid osteoma, which is repetitive, constant and present from the outset. Stress is laid on the difficulty of diagnosis with conventional radiological methods. MRI, on the other hand, was positive in 7 of the 9 cases, while scintigraphy constantly showed augmented uptake by the lesion, a picture that persisted over time thanks to the marked affinity of the tracer for osteoid tissue. Excision of the neoformation en bloc was undertaken in all 9 cases.

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