The typical patient is an older adolescent or young adult.
Clinical findings:
(1
) persistent, throbbing joint pain that occurs at rest
(2) variable bone pain
(3) pain relieved by aspirin
(4) joint stiffness
(5) muscle atrophy
(6) reduced/restricted joint movement
(7) reduced physical activities
Pathology:
(1) The classic osteoma is located in cortical bone and has a thick sclerotic rim of bone around a central radiolucent nidus.
(2) Osteomas located in the subperiosteum or cancellous bone may lack the sclerotic rim and/or the central nidus, but these may appear with time.
Reasons for a delay in diagnosis:
(1)
difficulty visualizing on imaging studies, especially if sclerotic bone and nidus are absent
(2) misdiagnosis as synovitis, rheumatoid arthritis, chondromalacia or psychogenic
(3) insufficient clinical information given to the radiologist
(4) failure to provide follow-up
Examination of X-rays:
(1)
Bones adjacent to joint should be carefully examined in a patient with suggestive clinical findings.
(2) Repeat X-rays at 8-12 months to see if a nidus has appeared.
(3) Bone scintigraphy can be helpful in identifying the tumor.
(4) CT or MRI can be helpful in precisely locating the tumor.
Complete resection of the tumor results in pain relief.
