The Diagnostic Challenge of Osteoid Osteoma in the Bones of the Hand-A Case Series

Osteoid osteoma (OO) is a benign bone tumor that rarely occurs in the bones of the hand. Due to the comparatively non-specific symptoms when occurring in the hand, OO is often misdiagnosed at first presentation, posing a diagnostic challenge. In the present case study, six cases of phalangeal and carpal OO, treated surgically at our department between 2006 and 2020, were retrospectively reviewed. We compared all cases regarding demographic data, clinical presentation, imaging findings, time to diagnosis, surgical treatment, and clinical outcome in follow-up examinations. When OO occurs in the bones of the hand, it can lead to swelling and deformities, such as enlargement of the affected bone and nail hypertrophy. Initial misdiagnoses such as primary bone tumors other than OO, tendinitis, osteomyelitis, or arthritis are common. Most of the presented cases showed a prolonged time until diagnosis, whereby the primarily performed imaging modality was often not sensitive. CT proved to be the most sensitive sectional imaging modality for diagnosing OO. With adequate surgical treatment, complications and recurrence are rare.

Automated summary

Osteoid osteoma (OO) is a rare benign bone tumor in the hand. Misdiagnosis is common due to non-specific symptoms, posing a diagnostic challenge. In this case study, six phalangeal and carpal OO cases were retrospectively reviewed and compared in terms of demographics, clinical presentation, imaging findings, diagnosis time, surgical treatment, and outcomes. Swelling, bone enlargement, and nail hypertrophy are common manifestations. CT is the most sensitive imaging modality for diagnosing OO. Adequate surgical treatment leads to rare complications and recurrence.