Objectives: Osteoid osteoma in the hand, especially in the phalanges is presented with nonspesific clinical and radiologic findings and are seen infrequently in that localization. Therefore, the diagnosis of osteoid osteomas in these localization is difficult. In present study, we evaluated seven phalangeal osteoid osteomas in hand with respect to late diagnosis.
Patients and methods: Seven patients (5 females, 2 males; mean age 21 years; range 17 to 23 years) who underwent surgery for hand phalangeal osteoid osteoma were investigated. Lesions were seen at four cases in right hand and at three cases in left hand. Twelve months was the longest diagnosis time while the earliest diagnosis time is 4 months among seven cases (mean 9 months).
Results: In all cases lesions were seen in proximal falanges. The affected fingers were the second finger in four patients, third finger in one patient and fourth finger in two patients. All patients had been treated with nonsteroidal anti enflamatuar drugs before the diagnosis. Symptoms were relieved but did not disappear completely. The diagnosis was done by scintigraphy with increase activity and the nidus localization in some patients by computed tomography but by conventional radiograpy diagnosis was done in none of patients. Histopathological examinations of the peroperative biopsies confirmed diagnosis of osteoid osteoma in all cases. In two cases, lesions were treated by high speed burr, at the rest five patients were curettaged.
Conclusion: Osteoid osteoma should be kept in mind in situations such as, painless swelling in hand fingers without trauma, prolonged pain and swelling after minimal trauma, single finger clubbing deformity, and bone scintigraphy and multisliced CT should be performed beside conventional radiography.