Osteoid osteoma of the foot: Presentation, treatment and outcome of a multicentre cohort

Maria A. Smolle, Magdalena M. Gilg, Felix Machacek, Miroslav Smerdelj, Per Ulf Tunn, Blaz Mavcic, Nenad Lujic, Jelena Sopta, Lauris Repsa, Jasminka Igrec, Andreas Leithner, Marko Bergovec (Coresponding Author)

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Osteoid osteomas of the foot are rare, with a varying and atypical clinical as well as radiological presentation impeding early diagnosis and treatment. The aim of the present multicentre study was to 1) analyze epidemiological, clinical and radiological findings of patients with foot osteoid osteomas and to 2) deduce a diagnostic algorithm based on the findings. Methods: A total of 37 patients (25 males, 67.6%, mean age 23.9 years, range 8–57 years) with osteoid osteomas of the foot were retrospectively included, treated between 2000 and 2014 at 6 participating tertiary tumor centres. Radiographic images were analyzed, as were patients’ minor and major complaints, pain relief and recurrence. Results: Most osteoid osteomas were located in the midfoot (n = 16) and hindfoot (n = 14). Painful lesions were present in all but one patient (97.3%). Symptom duration was similar for hindfoot and midfoot/forefoot (p = 0.331). Cortical lesions required fewer x‑rays for diagnosis than lesions at other sites (p = 0.026). A typical nidus could be detected in only 23/37 of x‑rays (62.2%), compared to 25/29 CT scans (86.2%) and 11/22 MRIs (50%). Aspirin test was positive in 18/20 patients (90%), 31 patients (83.8%) underwent open surgery. Pain relief was achieved in 34/36 patients (outcome unknown in one), whilst pain persisted in two patients with later confirmed recurrence. Conclusions: As previously reported, CT scans seem to be superior to MRIs towards detection of the typical nidus in foot osteoid osteomas. In patients with unclear pain of the foot and inconclusive x‑rays, osteoid osteoma should be considered as differential diagnosis.

Original languageEnglish
JournalWiener Klinische Wochenschrift
DOIs
Publication statusAccepted/In press - 2021
Externally publishedYes

Keywords*

  • Diagnosis
  • Foot tumour
  • Osteoid osteoma
  • Radiology
  • Symptoms

Field of Science*

  • 3.2 Clinical medicine

Publication Type*

  • 1.1. Scientific article indexed in Web of Science and/or Scopus database

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