An Uncommon Mass in The Distal Ulna;  A Case of Atypical Osteoid Osteoma

Mohammed M.A. Barakat; Kadir Ertem; Hüseyin Utku Özdeş

doi:10.58600/eurjther2595

Authors

Mohammed M.A. Barakat Orthopaedics and Traumatology Department, Turgut Özal Medical Center, İnönü University, Malatya, Turkiye https://orcid.org/0009-0008-6900-1614
Kadir Ertem Orthopaedics and Traumatology Department, Turgut Özal Medical Center, İnönü University, Malatya, Turkiye https://orcid.org/0000-0002-8892-494X
Hüseyin Utku Özdeş Orthopaedics and Traumatology Department, Turgut Özal Medical Center, İnönü University Medical School, Malatya, Turkiye https://orcid.org/0000-0003-4437-9860

DOI:

https://doi.org/10.58600/eurjther2595

Keywords:

Case report, Osteoma, ulna

Abstract

Osteoid osteoma (OO) is a benign osteoblastic tumor that commonly occurs in the diaphysis of long bones but is rarely found in peri-articular locations, particularly the wrist. This case report describes a 19-year-old female who presented with chronic wrist pain lasting two years, accompanied by nocturnal exacerbation and tenderness over the distal ulna. Imaging revealed a radiolucent lesion with a nidus, leading to a diagnosis of OO, later confirmed histologically following surgical excision. Differential diagnoses such as ulnar impingement syndrome, triangular fibrocartilage complex (TFCC) injuries, aneurysmal bone cyst (ABC), and giant cell tumor (GCT) were considered and ruled out through clinical and radiological findings. The patient experienced significant pain relief and regained full wrist function postoperatively. This report emphasizes the rarity of OO in the distal ulna and the importance of advanced imaging and a thorough differential diagnosis in managing persistent wrist pain.

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References

Themistocleous GS, Chloros GD, Benetos IS, Efstathopoulos DG, Gerostathopoulos NE, Soucacos PN. Osteoid osteoma of the upper extremity. A diagnostic challenge. Chir Main. 2006 Jun;25(2):69-76. https://doi.org/10.1016/j.main.2006.02.001

Kalb K, Schlör U, Meier M, Schmitt R, Lanz U. Das Osteoidosteom im Bereich der Hand und des Handgelenks [Osteoid osteoma of the hand and wrist]. Handchir Mikrochir Plast Chir. 2004 Dec;36(6):405-10. https://doi.org/10.1055/s-2004-830434

Yadav SK, Rajnish RK, Prakash V, Nalwa A. Malignant giant cell tumour of distal ulna. BMJ Case Rep. 2024 Feb 13;17(2):e258047. https://doi.org/10.1136/bcr-2023-258047

Aycan OE, Sökücü S, Özer D, Çetinkaya E, Arıkan Y, Kabukçuoğlu YS. Primary bone tumors and tumor like lesions of the ulna. Acta Orthop Traumatol Turc. 2019 Jan;53(1):30-34. https://doi.org/10.1016/j.aott.2018.04.005

Sangiorgio A, Oldrini LM, Candrian C, Errani C, Filardo G. Radiofrequency ablation is as safe and effective as surgical excision for spinal osteoid osteoma: a systematic review and meta-analysis. Eur Spine J. 2023 Jan;32(1):210-220. https://doi.org/10.1007/s00586-022-07411-8

Orth P, Kohn D. Diagnostik und Therapie des Osteoidosteoms. Diagnostics and treatment of osteoid osteoma. Orthopade. 2017 Jun;46(6):510-521. https://doi.org/10.1007/s00132-017-3428-0

Palussière J, A. Pellerin-Guignard, E. Descat, F. Cornélis, F. Dixmérias, [Radiofrequency ablation of bone tumours, Diagnostic and Interventional Imaging,Volume 93, Issue 9, Pages 680-684], ISSN 2211-5684. https://doi.org/10.1016/j.diii.2012.06.008