Journal of Orthopaedic Case Reports最新文献

{"title":"Superficial Temporal Artery Pseudoaneurysm Following Head Trauma from a Lacrosse Ball: A Case Report.","authors":"Joshua Marwede, Nathan Fitton","doi":"10.13107/jocr.2026.v16.i04.7102","DOIUrl":"https://doi.org/10.13107/jocr.2026.v16.i04.7102","url":null,"abstract":"<p><strong>Introduction: </strong>Superficial temporal artery pseudoaneurysm is a rare vascular complication of blunt head trauma and may be overlooked due to delayed presentation and minimal initial findings.</p><p><strong>Case report: </strong>A helmeted adolescent lacrosse player sustained blunt trauma to the right superolateral forehead after being struck by a lacrosse ball. He subsequently developed a progressively enlarging, pulsatile scalp mass. Point-of-care ultrasound demonstrated Doppler flow within the lesion, and further evaluation with ultrasound and computed tomography confirmed a pseudoaneurysm arising from the frontal branch of the superficial temporal artery. The patient underwent surgical excision and ligation of the affected vessel without complications.</p><p><strong>Conclusion: </strong>Early recognition and appropriate imaging are essential for the diagnosis of superficial temporal artery pseudoaneurysm and allow timely surgical management with excellent clinical outcomes.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 4","pages":"235-237"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13062390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147674518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tips for Accurate Beath Pin Length Measurement While Using an Arthroscopic Jig to Avoid Neurovascular Injury Due to Over Penetration (Hit-Pat's Method).","authors":"Hitendra G Patil, Milind V Pimprikar, Chinar K Patil","doi":"10.13107/jocr.2026.v16.i04.7142","DOIUrl":"https://doi.org/10.13107/jocr.2026.v16.i04.7142","url":null,"abstract":"<p><strong>Introduction: </strong>Arthroscopic jigs are specialized surgical instruments used in arthroscopy for drilling bone tunnels at the desired location. Neurovascular complications are known due to accidental over penetration of the beath pin in the posterior compartment.</p><p><strong>Surgical technique: </strong>We have provided a simple method to determine the minimum[t1.1] length needed of the beath pin so that when the chuck of the drill touches the stopper of the drill sleeve, we are sure that the beath pin has just exited at the desired point marked by the targeting guide and cannot go beyond that.</p><p><strong>Conclusion: </strong>Our technique of accurate beath pin measurement avoids over penetration of beath pin while using an Arthroscopy jig and thus avoids neurovascular complications.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 4","pages":"337-339"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13062416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147674542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cavernous Hemangioma Masquerading as a Ganglion Cyst of the Flexors of the Index Finger: A Case Report.","authors":"Saikat Jena, Mihir Maniar, Aashiket Sable, Nishant Dubey, Rohit Singh, Saurabh Yadav","doi":"10.13107/jocr.2026.v16.i04.7140","DOIUrl":"https://doi.org/10.13107/jocr.2026.v16.i04.7140","url":null,"abstract":"<p><strong>Introduction: </strong>Vascular lesions, such as cavernous hemangiomas of the finger's flexor tendon sheath are uncommon and can easily be mistaken for more common masses, such as ganglion cysts. Early recognition is important to plan appropriate imaging and excision with correct surgical technique.</p><p><strong>Case report: </strong>We report a 60-year-old female who presented with a painless, slowly enlarging subcutaneous swelling over the palmar aspect of her right hand. The initial clinical impression was a ganglion cyst of the flexor sheath. Ultrasound suggested a hypoechoic lesion without any internal vascular flow on Doppler. However, intraoperative findings revealed a vascular mass firmly adherent to the flexor tendon sheath. Complete excision was performed. Final histopathological examination confirmed the diagnosis of cavernous hemangioma. The patient had an uneventful recovery with full finger motion and no recurrence at annual follow-up.</p><p><strong>Conclusion: </strong>Cavernous hemangioma of the flexor tendon sheath can present like a ganglion cyst. Pre-operative suspicion (especially when imaging shows internal vascularity), careful operative planning, and complete excision are keys to a good outcome.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 4","pages":"333-336"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13062415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147674218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Escherichia hermannii: A Rare Pathogen in Implant-Associated Infection Following a Type III C Open Distal Radius Fracture - A Case Report.","authors":"M Jyothiprasanth, C R Jithin, S Venkatesh Kumar, Rohini Venkatesh, T P Ajinas, Mohamed Hadi Mansoor","doi":"10.13107/jocr.2026.v16.i04.7050","DOIUrl":"https://doi.org/10.13107/jocr.2026.v16.i04.7050","url":null,"abstract":"<p><strong>Introduction: </strong>Escherichia hermannii is an infrequent monomicrobial pathogen in human infections. Notably, it has never been documented as the sole isolate in cases of infected radial shaft fractures.</p><p><strong>Case report: </strong>This report presents a case of a non-union in a distal third radius shaft fracture associated with an E. hermannii-infected implant that remained in situ. The patient, who suffered a crush injury 3 months prior, initially underwent open reduction and internal fixation using a fibula strut graft secured with a titanium plate, along with primary wound closure. However, after 12 weeks, he developed an infection at the implant site, accompanied by a sinus tract. To address this complication, a repeat debridement was performed, and a retention strategy was implemented, allowing the original implant to be preserved.</p><p><strong>Conclusion: </strong>The patient was treated with intravenous meropenem for 7 days, followed by an 11-week course of oral ciprofloxacin. At the conclusion of treatment, he remained free of infection, asymptomatic, and was able to continue working with excellent functional outcomes.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 4","pages":"94-98"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13062392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147674267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional Outcome of Unstable Intertrochanteric Femur Fracture Treated Surgically With Long Proximal Femoral Nail.","authors":"R R Rajkumar, Soundararajan Karuppanan, V Sudhir, Muthukannan Hari Sivanandan, S Balaji","doi":"10.13107/jocr.2026.v16.i04.7150","DOIUrl":"https://doi.org/10.13107/jocr.2026.v16.i04.7150","url":null,"abstract":"<p><strong>Introduction: </strong>As the world's population ages, hip fractures become more common. The global incidence of hip fractures will rise to a million per year by 2040. Intertrochanteric femoral fractures are common fracture in older people, typically caused by low-energy falls. These fractures are also classified based on their stability, with unstable fracture patterns posing more challenges for surgical therapy and potentially resulting in worse functional recovery. Surgical fixation is the most effective treatment for these fractures since it restores motion while reducing complications. Intertrochanteric fractures occur between the lesser and greater trochanters of the femur. Unstable intertrochanteric fractures exhibit medial cortical comminution, fracture planes with reverse obliquity, and subtrochanteric extension. These characteristics contribute to the difficulty of achieving and maintaining reduction, as well as the likelihood of malunion, non-union, and eventual functional limitation.</p><p><strong>Aims and objectives: </strong>To evaluate the functional outcomes of patients with unstable intertrochanteric femur fractures who undergo surgical treatment using a long proximal femoral nail (PFN) and to assess complication rates, radiographic evaluation, return to daily activities, and patient satisfaction.</p><p><strong>Materials and methods: </strong>This prospective cross-sectional study was conducted in the Department of Orthopaedics, Vinayaka Mission's Kirupananda Variyar Medical College, from November 2022 to September 2025. Thirty patients aged above 18 years presenting with unstable intertrochanteric femur fractures (Boyd and Griffin types I-IV) were included and treated surgically with a long PFN.</p><p><strong>Results: </strong>The mean Harris Hip score (HHS) at the 3rd and 6th months after surgery was 75 ± 7.5 (72-77) and 87 ± 6.6 (84-89), respectively, with a statistically significant (P < 0.001) improvement. A significant (P < 0.05) increase in proportion from 3% in 3 months to 40% in 6 months in an excellent HHS. The mean hip disability and osteoarthritis outcome score (HOOS)-12 pain, function, quality of life (QoL), and summary of the study participants at the pre-operative stage were 29.2 ± 3.9, 34.6 ± 5.8, 26.3 ± 7, and 30 ± 5.4, respectively. In the 3rd and 6th months, there were significant improvements in all domains of the HOOS-12 score.</p><p><strong>Conclusion: </strong>The HHS was significantly increased at 6 months compared to HHS at 3 months. All the domains (pain, function, QoL, and summary) of the HOOS-12 and Visual Analog Scale pain scores increased significantly at the 3rd and 6th months from pre-operative.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 4","pages":"359-365"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13062342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147674285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional and Radiological Outcome of Osteoporotic Vertebral Fracture Managed with Balloon Kyphoplasty - A Prospective Study.","authors":"Charanjit Singh Dhillon, Chetan Pophale, Koteshwar Rao Mattigunta, M Sabarinath, Tarun Roy, Mukhesh Thangavel","doi":"10.13107/jocr.2026.v16.i04.7154","DOIUrl":"https://doi.org/10.13107/jocr.2026.v16.i04.7154","url":null,"abstract":"<p><strong>Introduction: </strong>Vertebral compression fractures (VCFs) affect significant portions of the body. Balloon kyphoplasty (BKP) is a minimally invasive treatment that offers pain relief and restoration of vertebral body height. This study aimed to determine the functional and radiological outcomes of patients with osteoporotic vertebral fractures treated with BKP.</p><p><strong>Materials and methods: </strong>This prospective study included 40 patients from MIOT Hospital, Chennai, between March and December 2022. Patients with back injuries from trivial trauma were evaluated for osteoporotic VCFs using X-rays, classified according to the AO and DENNIS systems, and neurologically assessed. Pre- and post-operative (pre-op and post-operative) metrics, including the Visual Analog Scale (VAS) for back pain, Oswestry scores, anterior vertebral body height, and kyphotic angle, were documented.</p><p><strong>Results: </strong>Most patients were female (82.5%), and 92.5% had no history of spinal surgery. Bone Mineral Density was 60% with a T-score of -2.5 and 40% with -3.5. According to Dennis's classification, 57.5% of the patients had Type B fractures, with none having posterior compression or neurological deficits. The kyphotic angle varied by 45% at 10°. There was a significant increase in anterior vertebral body height from 24 ± 2.93 to 28 ± 2.48 (P = 0.005), decreased VAS scores (8.53 ± 0.68 pre-operative to 2.28 ± 0.91 at 6 months, P < 0.0001), and reduced Oswestry disability index (ODI) (27.98 ± 2.25 pre-operative to 12.80 ± 1.98 at 3 months, P < 0.0001). Beck's index improved from 0.83 ± 0.05 pre-operative to 1.01 ± 0.11 post-op (P < 0.0001).</p><p><strong>Conclusion: </strong>BKP improved pain, function, and radiological outcomes in osteoporotic vertebral fractures, with significant improvements in VAS, ODI, vertebral height, kyphotic angle, and Beck's index, demonstrating safety and minimal complications.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 4","pages":"371-376"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13062382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147674318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intertrochanteric Femur Fracture in Severe Peripheral Vascular Disease Complicated by Acute Limb Ischemia and Amputation: A Case Report.","authors":"Killi Madhu Babu, Sai Surya Dinesh Pydi, Vishal Kumar, Sandeep Patel","doi":"10.13107/jocr.2026.v16.i04.7078","DOIUrl":"https://doi.org/10.13107/jocr.2026.v16.i04.7078","url":null,"abstract":"<p><strong>Introduction: </strong>Intertrochanteric (IT) femur fractures are among the most commonly encountered injuries in orthopedic practice and are typically managed successfully with internal fixation using cephalomedullary devices. Vascular complications following such procedures are rare and are most often limited to localized arterial injury or pseudoaneurysm formation. Progression to acute limb ischemia with subsequent limb loss is exceptionally uncommon, particularly in the setting of routine fracture fixation. The presence of severe peripheral vascular disease (PVD) may significantly alter this otherwise predictable clinical course.</p><p><strong>Case report: </strong>We report the case of a 50-year-old male with advanced PVD who sustained a right IT femur fracture following a slip and fall at home. After thorough medical optimization and multidisciplinary evaluation, the patient underwent closed reduction and internal fixation with a proximal femoral nail. Despite an initially uneventful intraoperative course, the patient developed acute-on-chronic limb ischemia in the post-operative period, characterized by progressive loss of distal perfusion and tissue viability. Imaging confirmed diffuse multilevel arterial disease with poor distal runoff. Despite prompt anticoagulation, fasciotomy, and vascular consultation, limb salvage was not possible, and the patient ultimately required staged below-knee followed by definitive above-knee amputation.</p><p><strong>Conclusion: </strong>This case highlights a rare but catastrophic complication following IT fracture fixation in a patient with severe PVD. It underscores the critical importance of meticulous pre-operative vascular assessment, cautious use of traction during fracture reduction, early multidisciplinary involvement, and realistic perioperative counseling regarding the potential risk of acute limb ischemia and limb loss in high-risk patients.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 4","pages":"167-171"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13062351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147674334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Rare and Interesting Case of Sciatic Nerve Compression Due to Proximal Femoral Osteochondroma in a Young Adult - A Case Report.","authors":"Ninad Kishor Honwadkar, Eknath Deosing Pawar, Abhiram T V, Aravind Chanal, Atharva Alaspure","doi":"10.13107/jocr.2026.v16.i04.7132","DOIUrl":"https://doi.org/10.13107/jocr.2026.v16.i04.7132","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Osteochondromas (OCs) are benign hamartomatous lesions composed of cartilage and bone, arising from aberrant growth-plate cartilage. They characteristically project from the bone surface through the cortex and grow by endochondral ossification beneath the periosteum. Lesion growth usually parallels skeletal growth and typically ceases after physeal closure, although minimal growth of the cartilage cap may persist and generally stops by the third decade of life.This developmental mechanism explains the predilection for involvement of the distal femur, proximal tibia, and proximal humerus. Most OCs are asymptomatic and do not require surgical intervention. However, intra-articular or atypically located lesions may produce pain, restricted joint movement, or compression of adjacent neurovascular structures, necessitating operative management.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Case report: &lt;/strong&gt;A 39-year-old male presented to the outpatient department with complaints of left-sided hip pain associated with restricted range of motion and radiating pain along the posterior aspect of the left thigh, accompanied by buttock pain for 6 months. The symptoms had gradually progressed and were aggravated by activity. The patient also reported mild paresthesia over the anteromedial aspect of the left knee and the dorsum of the left foot. He noticed a gradually enlarging, ill-defined mass in the left gluteal region during the same period.On clinical examination, a firm, immobile mass measuring approximately 10 × 6 cm was palpated in the left buttock. Left hip flexion was limited to 60° due to pain. Neurological examination revealed weakness of both plantar flexion and dorsiflexion of the left ankle.The patient had previously received conservative treatment, including rest, non-steroidal anti-inflammatory drugs, and physiotherapy at another institution, with no improvement in symptoms.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The lesion was excised through a posterior approach with the patient positioned in the right lateral decubitus position, as described by Yu et al. The sciatic nerve was identified, carefully dissected, and protected throughout the procedure. The OCs were excised using an osteotome. Intraoperative assessment of the femoral neck revealed no cortical defects or fractures, and no fixation was required. Histopathological examination confirmed the diagnosis of OCs with a cartilaginous cap measuring &lt;1 cm.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Sciatic nerve compression symptoms in non-traumatic cases in young adults may result due to intra or extraspinal causes, depending on the anatomical site of involvement. Lumbar intervertebral disc prolapse and spinal canal stenosis constitute the most frequent intraspinal causes. Extraspinal etiologies are comparatively rare and include conditions such as piriformis syndrome and pelvic bone lesions. Benign bone tumors, particularly OCs, though uncommon, should be considered as a potential source of sciat","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 4","pages":"312-316"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13062422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147674360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rare Presentation of Chronic Anterior Instability with Concomitant Triad of Anterior Labral Periosteal Sleeve Avulsion, Hill-Sachs, and Humeral Avulsion of the Glenohumeral Ligament Lesions: A Case Report.","authors":"Hady Ezzeddine, Rita Saad, Wendy Ghanem, Mohamad Badra, Ramzi Moucharafieh, Ziad Noun","doi":"10.13107/jocr.2026.v16.i04.7066","DOIUrl":"https://doi.org/10.13107/jocr.2026.v16.i04.7066","url":null,"abstract":"<p><strong>Introduction: </strong>Traumatic anterior shoulder instability is common in young patients; however, the simultaneous occurrence of an anterior labral periosteal sleeve avulsion (ALPSA) lesion, Hill-Sachs defect, and humeral avulsion of the glenohumeral ligament (HAGL) is exceptionally rare. Managing multiple concurrent soft-tissue and bony injuries presents significant diagnostic and therapeutic challenges. This report describes a unique case of combined ALPSA, Hill-Sachs, and HAGL lesions treated with an all-arthroscopic approach, highlighting the importance of comprehensive evaluation and tailored surgical planning in complex instability patterns.</p><p><strong>Case report: </strong>A 17-year-old female sustained a traumatic shoulder injury resulting in recurrent anterior dislocations, progressive pain, and functional weakness. Imaging revealed the coexistence of an ALPSA lesion, a significant Hill-Sachs defect, and a HAGL lesion. Given the complexity of instability, an all-arthroscopic repair strategy was adopted. The procedure included arthroscopic ALPSA repair to restore labral integrity, Hill-Sachs remplissage to address the engaging humeral defect, and arthroscopic HAGL repair using strategic anchor placement and precise suture management to re-establish capsuloligamentous continuity. Postoperative rehabilitation progressed uneventfully, and at 18 months follow-up, the patient demonstrated a near-normal range of motion, excellent functional recovery, and no recurrence of instability.</p><p><strong>Conclusion: </strong>The coexistence of ALPSA, Hill-Sachs, and HAGL lesions represents a rare and challenging clinical scenario. This case illustrates that a carefully planned all-arthroscopic approach can successfully restore shoulder stability and function while minimizing morbidity. Thorough assessment and individualized treatment strategies are essential for optimal outcomes in complex instability presentations. Further research is warranted to assess the long-term results of combined arthroscopic repair in such rare lesion patterns.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 4","pages":"133-139"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13062363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147674428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unusual Presentation of Spinal Osteoid Osteoma: A Case Report.","authors":"Mehmet Erkilinc","doi":"10.13107/jocr.2026.v16.i04.7046","DOIUrl":"https://doi.org/10.13107/jocr.2026.v16.i04.7046","url":null,"abstract":"<p><strong>Introduction: </strong>Osteoid osteoma (OO) is a benign osteogenic tumor that most commonly affects long bones, accounting for 2-3% of primary bone tumors. Spinal involvement is relatively rare, representing 6-20% of cases, with the lumbar spine being the most frequently affected region. Typical spinal OO presents with painful scoliosis and nocturnal pain relieved by non-steroidal anti-inflammatory drugs (NSAIDs). However, atypical presentations may occur when lesions are located adjacent to neural structures, leading to radicular symptoms and poor NSAID response. This case report describes an unusual presentation of OO in the L4 superior articular process, manifesting with back and leg pain, minimal NSAID responsiveness, and nerve root irritation.</p><p><strong>Case report: </strong>A 17-year-old male presented with a 6-month history of back and leg pain, fluctuating between 3/10 and 7/10 in severity, with associated numbness in the L3 dermatome. Examination revealed painful paraspinal palpation and a positive straight leg raise on the right side, without motor weakness or reflex abnormalities. Magnetic resonance imaging demonstrated non-specific inflammatory changes, whereas computed tomography (CT) confirmed a 9 × 9 mm nidus in the right superior articular process of L4. Given the lesion's proximity to neural structures, radiofrequency ablation was deemed unsafe, and surgical excision was performed. The patient underwent open resection of the nidus with preservation of the inferior facet joint. Immediate post-operative resolution of leg pain was noted, and at 3-month follow-up, the patient reported complete resolution of both back and leg pain, with no recurrence of symptoms.</p><p><strong>Conclusion: </strong>This case highlights an atypical presentation of spinal OO, characterized by radicular symptoms and poor NSAID response due to nerve root inflammation. It underscores the importance of considering OO in the differential diagnosis of adolescent back and leg pain, even in the absence of classic features. CT imaging remains essential for definitive diagnosis, and surgical excision provides safe and effective treatment when minimally invasive options are contraindicated by lesion proximity to neural structures.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 4","pages":"86-89"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13062352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147673898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}