Case Report

Osteoid Osteoma of the Radial Styloid Mimicking de Quervain Tenosynovitis

Authors: George D. Chloros, MD, George S. Themistocleous, MD, DSc, Panayiotis J. Papagelopoulos, MD, DSc, Lubna Khaldi, MD, Dimitrios G. Efstathopoulos, MD, DSc, Panayotis N. Soucacos, MD, FACS

Abstract

A very unusual location of osteoid osteoma arising in the radial styloid is presented, which strongly mimicked de Quervain tenosynovitis, thereby resulting in the patient undergoing an additional unnecessary operation and a substantial delay of more than 2 years in diagnosis.


Key Points


* Osteoid osteomas are rare in the upper extremity; they frequently mimic other etiologies and their diagnosis is challenging.


* A careful history and evaluation of the quality of the pain is essential.


* de Quervain tenosynovitis is a clinical diagnosis; however, this should be confirmed with imaging to rule out any bony etiology.


* Even using plain radiographs to exclude a bony etiology, diagnosis may still be a challenge, as de Quervain tenosynovitis is associated with bony abnormalities in the area of the radial styloid.


* The diagnosis of osteoid osteomas in the upper extremity may be delayed and cause significant morbidity.

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References

1. Themistocleous GS, Chloros GD, Benetos IS, et al. Osteoid osteoma of the upper extremity: a diagnostic challenge. Chir Main 2006;25:69–76.
 
2. Dorfman HD, Czerniak B. Benign osteoblastic tumors. In: Dorfman HD, Czerniak B, eds. Bone Tumors. St. Louis, Mosby, 1998, pp 85–127.
 
3. Themistocleous GS, Chloros GD, Mavrogenis AF, et al. Unusual presentation of osteoid osteoma of the scaphoid. Arch Orthop Trauma Surg 2005;125:482–485.
 
4. Liu PT, Chivers FS, Roberts CC, et al. Imaging of osteoid osteoma with dynamic gadolinium-enhanced MR imaging. Radiology 2003;227:691–700.
 
5. DeSmet L, Fabry G. Osteoid osteoma of the hand and carpus: peculiar presentations and imaging. Acta Orthop Belg 1995;61:113–116.
 
6. Nyska M, Floman Y, Fast A. Osseous involvement in de Quervain's disease. Clin Orthop Relat Res1984;186:159–161.
 
7. Leao L. De Quervain's disease; a clinical and anatomical study. J Bone Joint Surg Am 1958;40-A:1063–1070.
 
8. Chien AJ, Jacobson JA, Martel W, et al. Focal radial styloid abnormality as a manifestation of de Quervain tenosynovitis. AJR Am J Roentgenol 2001;177:1383–1386.
 
9. Blair WF, Kube WJ. Osteoid osteoma in a distal radial epiphysis: case report. Clin Orthop Relat Res1977;126:160–161.
 
10. Clermont D, Partoune E, Lejeune G. [Osteoid osteoma of the distal end of the radius. Review of the literature in light of a case.] Ann Chir Main Memb Super 1991;10:146–147.
 
11. DeSmet L. Synovitis of the wrist joint caused by an intra-articular perforation of an osteoid osteoma of the radial styloid. Clin Rheumatol 2000;19:229–230.
 
12. Fromm B, Martini A, Schmidt E. Osteoid osteoma of the radial styloid mimicking stenosing tenosynovitis: a case report. J Hand Surg [Br] 1992;17:236–238.
 
13. Rosenthal DI, Hornicek FJ, Torriani M, et al. Osteoid osteoma: percutaneous treatment with radiofrequency energy. Radiology 2003;229:171–175.