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Query: UNIPROT:P50502 (Hip)
 7,003 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Osteoid osteoma, an infrequent but important cause of musculoskeletal pain, is often difficult to diagnose. We present a case of a 31-year-old man who, for 2 years, had left groin pain radiating to the thigh. Symptoms began 1 month after a motorcycle crash in which he sustained only shin abrasions. Initial spine and hip radiographs were negative. Treatment with naproxen provided significant relief, but the symptoms gradually worsened over 6 months. An electromyogram and lumbar magnetic resonance imaging (MRI) of the left lower leg were unremarkable. Hip MRI revealed edema without fracture. Prophylactic femoral pinning for impending stress fracture provided no relief. Rheumatologic evaluation revealed normal serologies and synovial fluid. Cyclobenzaprine and sulfasalazine were started and provided mild relief. At presentation to our institution, he was in significant discomfort, but could ride a bicycle for exercise and was completing a home exercise program. He had antalgic gait and globally restricted hip motion with end-range pain. A neurologic examination showed no abnormalities. Hip and pelvis computed tomography scan revealed increased sclerosis of the femoral head, with a central lucency suggestive of osteoid osteoma. This was confirmed by biopsy. Radiofrequency ablation provided significant symptom relief.
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PMID:The diagnostic and therapeutic challenge of femoral head osteoid osteoma presenting as thigh pain: a case report. 1280 46

Bone tumours and tumour-like lesions of the hip in children are rare. Signs and symptoms of these tumours are generally nonspecific. Delay of diagnosis is not uncommon. A high index of suspicion in young patients presenting with persistent pain and without history of trauma, that is unresolved with conservative therapy should prompt further investigation, including radiographs or computed tomography scan of the pelvis. In the experience of the Istituto Rizzoli, in patients less than 14 years (mean 9 years, ranged from 6 months to 14 years), 752 tumours and tumours-like lesions occurred in the pelvis or proximal femur, involving the hip. Tumour-like lesions accounted for 322 cases (simple bone cyst in 255, eosinophilic granuloma in 43, aneurismal bone cyst in 34), benign tumours for 340 cases (osteoid osteoma in 229, fibrous dysplasia in 63, exostosis in 48) and malignant tumours for 80 cases (Ewing's sarcoma in 53 and osteosarcoma in 27). The epidemiology, pathology, clinical presentation, and radiograph findings are discussed for each of these tumours.Treatment of these tumours differs from observation or minimally invasive treatment for most pseudotumoural lesions, intralesional excision or termoablation for benign bone tumours and wide resection for malignant bone tumours. In this latter group, chemotherapy is required and often administered pre- and postoperatively.
Hip Int
PMID:Tumours and tumour-like lesions of the hip in the paediatric age: a review of the Rizzoli experience. 1930 46

The atypical presentation of intra-articular osteoid osteoma in the hip joint frequently results in delayed diagnosis compared with the diagnosis of extra-articular osteoid osteoma. We present 2 cases of hip joint osteoid osteoma in children treated by hip arthroscopy. Intra-articular osteoid osteoma was suspected when computed tomography (CT) findings were reviewed. Of the various surgical options including wide-open or CT-guided minimally invasive techniques, arthroscopic excision was selected for our patients to avoid damage to the adjacent growth plate (the triradiate cartilage) and to treat concomitant synovitis. Under arthroscopic visualization, biopsy specimens were obtained first, and the lesions were excised. In both cases, postoperative CT showed complete excision and histologic examination confirmed the diagnosis. Both patients enjoyed excellent clinical outcomes. We conclude that the arthroscopic excision of the hip joint osteoid osteoma in children is effective because it causes minimal damage to normal bone or the adjacent growth plate, and because synovectomy for concomitant synovitis may be performed. Hip arthroscopy also yields a biopsy specimen adequate for pathologic examination.
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PMID:Arthroscopic excision of osteoid osteomas of the hip in children. 1970 Sep 81

Intra-articular osteoid osteoma (IAOO) is rare and non-specific both in clinical and radiographic presentations, thus often associated with delayed diagnosis. Synovitis and muscle atrophy occur in adult IAOO. Bony deformity can occur in children and has been ascribed to muscle contractures. We report a case of a child with IAOO in the femoral neck. There was an absence of muscle contracture during surgery, and therefore the femoral deformity may have been induced directly by IAOO in the early stage of the disease.
Hip Int
PMID:Osteoid osteoma of the femoral neck causes deformity in children: a case report. 2181 48

The purpose of this study was to present the case report of a 7-year-old patient who was treated with hip arthroscopy for an acetabular osteoid osteoma. A 7-year-old patient was referred to our clinic with hip pain. In the assessment of the patient, an acetabular osteoid osteoma was detected in his right hip; it was adjacent to his triradiate cartilage. An arthroscopic surgery was planned as an alternative to open safe hip dislocation. The osteoid osteoma was completely removed with hip arthroscopy. Postoperative CT scanning and histopathological analysis confirmed the diagnosis. Exposure of the acetabulum can be problematic in paediatric patients due to the potential risks of open safe dislocation. Hip arthroscopy can safely be used for benign hip lesions in paediatric patients. Level of evidence Case report, Level V.
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PMID:Arthroscopic excision of acetabular osteoid osteoma in a 7-year-old patient. 2471 76

Osteoid osteoma is a benign osteoblastic tumor that occurs in the subcortical shaft and metaphysis of the long bones of the lower extremities; however, intra-articular lesions are also possible. Intra-articular osteoid osteomas are rare, and clinical symptoms are often less specific and, thereby, may lead to misdiagnosis. The definitive treatment for osteoid osteoma is the excision of the nidus. We present the case of a 23-year-old man with a 4-year history of right anterior hip pain, subsequently diagnosed with a subarticular osteoid osteoma located in the right anterior acetabulum. Hip arthroscopic excision of the juxta-articular osteoid osteoma is presented as an effective treatment, with the advantage of less potential damage to normal bone and cartilage, as well as the additional benefits available with hip arthroscopy.
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PMID:Arthroscopic Excision of Acetabular Osteoid Osteoma: Computer Tomography-Guided Approach. 2605 84

Femoro-acetabular impingement is a common cause of hip pain in young athletes. Evaluation typically includes radiographs and magnetic resonance imaging. It is important to appreciate uncommon diagnoses and the role of complimentary imaging. This clinical vignette emphasizes the need complete imaging with CT in select case of atypical hip pain. We present a 19-year old soccer player who underwent seemingly successful arthroscopic FAI surgery but returned with pain. Computed tomography (CT) revealed osteoid osteoma of the lesser trochanter. The lesion was successfully treated with percutaneous CT guided radiofrequency ablation.
J Hip Preserv Surg 2016 Aug
PMID:Unrecognized osteoid osteoma of the proximal femur with associated cam impingement. 2758 64

Osteoid osteoma frequently requires surgical treatment, especially among young, active patients. However, surgeons are reluctant to perform open surgery for an osteoid osteoma of the femoral neck area because the conventional surgical approach requires a large incision in muscular patients, and percutaneous resection with a trephine has the attendant risk of subsequent fracture. Recently, arthroscopic excision of an osteoid osteoma has been reported as a less invasive, safer procedure than traditional open curettage. Hip arthroscopy using the burr-down technique under C-arm guidance to locate and remove the lesion of the femur neck has also shown promise. The presented technique minimizes muscle damage around the femur and enables surgeons to confirm complete resection of the lesion through direct, detailed visualization. Furthermore, early return to previous activity can be achieved after excising the lesion located at the calcar femorale, which is an area with a heavy weight-bearing load. The objective of this Technical Note was to describe our preferred technique for the surgical excision of osteoid osteoma located at the base of the femoral neck through the use of arthroscopy.
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PMID:Arthroscopic Excision of an Osteoid Osteoma of the Lesser Trochanter of the Femoral Neck. 2935 41

Intra-articular osteoid osteoma (IAOO) of the hip is a relatively rare diagnosis, but one that can closely mimic symptomatic presentation of femoroacetabular impingement (FAI). Although there are multiple case reports of osteoid osteoma (OO) in the hip, we present the largest case series of hip IAOO treated with hip arthroscopy and discuss limited patient-reported outcomes after treatment with hip arthroscopy. We retrospectively identified patients diagnosed with IAOO of the hip with confirmatory computed tomography, magnetic resonance imaging or biopsy diagnoses of OO. We analyzed lesion location, main presenting symptoms, symptom duration and treatment undertaken. For the patients who underwent hip arthroscopy for treatment of their IAOO, we reviewed patient-reported outcome scores when available. Forty patients with confirmed IAOO were identified. Thirteen underwent excision with hip arthroscopy. The most common presenting symptom was groin pain. In limited patients who had pre- and post-operative outcome scores, we found significant improvements in modified Harris Hip Score (mHHS), Hip Outcome Score-Activity of Daily Living (HOS-ADL) and international Hip Outcomes Tool (iHot33) scores. Compared with patients undergoing hip arthroscopy for FAI alone, baseline mHHS, HOS-ADL, Hip Outcome Score-Sport-Specific Subscale and iHot33 scores were almost identical. We found that the presenting symptoms of hip IAOO closely mimic symptomatic FAI, including groin pain and anterior hip pain, so it is important to keep IAOO of the hip in the differential diagnosis of hip pain. Based on our experience, arthroscopy can be an effective treatment option for excision of intra-articular OO and is especially effective in patients with concomitant FAI in treating both pathologies.
J Hip Preserv Surg 2018 Jan
PMID:Clinical presentation of intra-articular osteoid osteoma of the hip and preliminary outcomes after arthroscopic resection: a case series. 2942 56

Hip arthroscopic surgery has become a common technique during the past decade, leading to an increased number of arthroscopic hip revision surgeries. This study aimed to evaluate the clinical outcomes in a series of revision hip arthroscopies to analyse the causes of reoperation in the short to medium-term follow-up. We retrospectively analysed 22 patients who underwent arthroscopic hip revision surgery in our institute. All patients accepted a detailed physical examination and obtained radiographs to measure the centre edge angle, the alpha angle and the offset. Three-dimensional computed tomography was used to evaluate the deformities. The modified Harris Hip Score, visual analogue scale and patient self-reported satisfaction were collected and analysed preoperatively and postoperatively. Our results demonstrated that the modified Harris Hip Score improved from 52.8 to 81.6, and the visual analogue scale decreased from 5.0 to 1.1. Patient self-reported satisfaction was 8.5. In conclusion, patients who underwent arthroscopic hip revision surgery exhibited significant improvement in patient-centred outcomes in the short- to medium-term follow-up, and the outcomes indicated the effectiveness of revision surgery. Residual femoroacetabular impingement and extra-articular impingement are common reasons for arthroscopic hip revision surgery. Misdiagnosis of osteoid osteoma and relapse of synovial chondromatosis are also important reasons for revision.
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PMID:Clinical outcomes and causes of arthroscopic hip revision surgery. 3071 58


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