J Korean Soc Surg Hand.  2013 Sep;18(3):138-142. 10.12790/jkssh.2013.18.3.138.

Osteoid Osteoma of the Capitate with Extensor Tenosynovitis

• Bae SW
• Lee HS
• Choi YS
• Song BY

• KMID: 2194144
• DOI: http://doi.org/10.12790/jkssh.2013.18.3.138

Abstract

An osteoid osteoma is a benign bone tumor. It is most commonly found in the femur and tibia but only 5% to 15% occurs in hand. Osteoid osteoma of carpal bone has vague nature of symptoms including spontaneous dull aching causing delayed diagnosis and the late treatment. We had a patient with an osteoid osteoma of the capitate bone presenting with tenosynovitis. We present clinical and radiological findings including magnetic resonance imaging, surgical result, and a review of the current literature.

Keyword

Capitate bone; Bone neoplasm; Osteoid osteoma; Tenosynovitis

MeSH Terms

Bone Neoplasms
Capitate Bone
Carpal Bones
Delayed Diagnosis
Femur
Hand
Humans
Magnetic Resonance Imaging
Osteoma, Osteoid
Tenosynovitis
Tibia

Figure

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  Fig. 1. A photograph shows mild soft tissue swelling on the dorsum of the right wrist.

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  Fig. 2. (A) Anteroposterior radiograph of the right wrist shows a sclerosis area (arrow) of the distal pole of the capitate. (B) On lateral radiograph, there is cortical disruption (arrow) at the dorsal capitate with the overlying soft tissue swelling.

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  Fig. 3. (A) Coronal T1-weighted magnetic resonance image (MRI) of right wrist shows a well circumscribed lesion (arrow) with central low signal in the capitate. MRI conditions were as follows: magnet strength 3.0T, fast spin echo, repetition time 670 msec, echo time 30 msec, field of view 11×11 cm, 2.0 thickness. (B) On axial T2-weighted with fat-suppression MR image obtained at the midcarpal level, this lesion (arrow) shows a hypointense center surrounded by hyperintense rim. There are extensive high signal suggesting bone marrow edema pattern in the remaining capitate, trapezoid and hamate with tenosynovitis of extensor carpi radialis brevis (arrow head). MRI conditions were as follows: magnet strength 3.0T, fast spin echo, repetition time 3,490 msec, echo time 68 msec, field of view 10 × 10 cm, 3.0 thickness.

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  Fig. 4. (A) The degenerated cortical lesion was removed for exposing a nidus by osteotome. (B) A reddish oval shaped, 0.5 cm sized nidus.

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  Fig. 5. A photomicrograph (H&E, × 100) shows fibrovasuclar zone and irregular trabeculae of the woven bone.

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