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Intraarticular Osteoid Osteoma

Sonographic Findings in Three Patients with Radiographic, CT, and MR Imaging Correlation

¹ Department of Radiology, University of Michigan Medical Center, 1500 E. Medical Center Dr., Ann Arbor, MI 48109-0326.
² Present address: Department of Radiology, McMaster University, 1200 Main St. W., Hamilton, Ontario L8N 3Z5, Canada.
³ Valley Radiologists, Ltd., 5322 W. Northern Ave., Glendale, AZ 85301.
⁴ Department of Family Medicine and Orthopedic Surgery, Medsport Domino's Farms, 24 Frank Lloyd Wright Dr., Ann Arbor, MI 48105.
⁵ Department of Radiology, University of California San Diego Veterans Administration Medical Center, 3350 La Jolla Village Dr., San Diego, CA 92161.

View larger version (149K): [in a new window]   Fig. 1A. —42-year-old woman with osteoid osteoma of distal humerus. Sagittal sonogram of posterior humerus shows cortical irregularity (between solid straight arrows) at site of osteoid osteoma with adjacent focal hypoechoic synovitis (curved arrow). Also note cortical discontinuity with posterior acoustic enhancement (arrowheads) at the site of apparent hypoechoic osteoid osteoma nidus (open arrow).

View larger version (160K): [in a new window]   Fig. 1B. —42-year-old woman with osteoid osteoma of distal humerus. Axial sonogram of posterior humerus shows cortical irregularity (between long straight arrows) at site of osteoid osteoma with adjacent focal hypoechoic synovitis (curved arrow). Note small effusion in olecranon fossa (short arrow).

View larger version (100K): [in a new window]   Fig. 1C. —42-year-old woman with osteoid osteoma of distal humerus. Corresponding color Doppler axial sonogram of posterior humerus shows hyperemia (curved arrow) of focal synovitis with apparent vessel (straight arrow) entering cortex at site of osteoid osteoma.

View larger version (122K): [in a new window]   Fig. 1D. —42-year-old woman with osteoid osteoma of distal humerus. Axial T1-weighted spin-echo MR image (TR/TE, 50/18) shows intermediate signal osteoid osteoma (solid straight arrow) with internal low signal. Note adjacent synovitis (curved arrow) and bone marrow edema (open arrow).

View larger version (145K): [in a new window]   Fig. 1E. —42-year-old woman with osteoid osteoma of distal humerus. Lateral radiograph of elbow shows radiolucent nidus (straight arrow) with internal calcification and adjacent sclerosis (curved arrow).

View larger version (122K): [in a new window]   Fig. 1F. —42-year-old woman with osteoid osteoma of distal humerus. Axial CT image shows calcified osteoid osteoma (straight arrow) with adjacent periosteal new bone formation (curved arrow).

View larger version (137K): [in a new window]   Fig. 2A. —26-year-old man with osteoid osteoma of distal humerus. Sagittal sonogram of posterior humerus shows cortical irregularity (straight arrow) and adjacent hypoechoic synovitis (curved arrow) at site of osteoid osteoma.

View larger version (162K): [in a new window]   Fig. 2B. —26-year-old man with osteoid osteoma of distal humerus. Axial intermediate-weighted spin-echo MR image (TR/TE, 2000/30) shows intermediate signal osteoid osteoma (arrow).

View larger version (136K): [in a new window]   Fig. 2C. —26-year-old man with osteoid osteoma of distal humerus. Anteroposterior elbow radiograph shows lucent osteoid osteoma (arrow) with minimal surrounding sclerosis and possible intrinsic calcification.

View larger version (102K): [in a new window]   Fig. 2D. —26-year-old man with osteoid osteoma of distal humerus. Axial CT image shows low attenuation nidus (straight arrow) of osteoid osteoma with intrinsic calcification and surrounding sclerosis (curved arrow).

View larger version (123K): [in a new window]   Fig. 3A. —22-year-old woman with osteoid osteoma of second metatarsal bone. Dorsal sonogram of distal second metatarsal bone shows cortical irregularity (straight arrow) and adjacent focal hypoechoic synovitis (curved arrow) at site of osteoid osteoma.

View larger version (149K): [in a new window]   Fig. 3B. —22-year-old woman with osteoid osteoma of second metatarsal bone. Sagittal T2-weighted inversion recovery MR image (TR/TE 4845/30; inversion time, 140) shows focal increased signal of dorsal second metatarsal bone and adjacent soft tissues (arrow).

View larger version (85K): [in a new window]   Fig. 3C. —22-year-old woman with osteoid osteoma of second metatarsal bone. Lateral radiograph of foot shows focal lucency of distal second metatarsal bone (arrow).

View larger version (120K): [in a new window]   Fig. 3D. —22-year-old woman with osteoid osteoma of second metatarsal bone. Axial CT image shows focal low-attenuation nidus with sclerotic rim and focus of intrinsic calcification (arrow).

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