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Atypical Osteoid Osteoma of Proximal Femur and its Surgical Challenges: A Technical Note on ‘Wandering Nidus’ and Double Lesion

Volume 9 | Issue 1 | January-April 2023 | Page: 33-36 | Sitsabesan Chokkalingam, Arunan Murali, Roy Santhosham, Gopinath Menon DOI- https://doi.org/10.13107/ijpo.2023.v09.i01.153 Authors: Sitsabesan Chokkalingam [1] D Ortho., Arunan Murali [2] MD Rad., Roy Santhosham [2] MD Rad., Gopinath Menon [1] MS Ortho. [1] Department of Trauma & Orthopaedics, (SRIHER) Sri Ramachandra Institute of Higher […]

Epidemiology and Antibiotic Sensitivity Patterns in Pyogenic Bone and Joint Infections in Children

Volume 9 | Issue 1 | January-April 2023 | Page: 07-12 | Amit Sharma, G Nirmal Raj Gopinathan, Garima Sharma, Pallavi Sharma, Sange Negi DOI- https://doi.org/10.13107/ijpo.2023.v09.i01.149 Authors: Amit Sharma [1] MS Ortho., G Nirmal Raj Gopinathan [2] MS Ortho., Garima Sharma [3] MD Microbiology, Pallavi Sharma [4] MS ObGy., Sange Negi [1] MS Ortho. [1] […]

Atypical Osteoid Osteoma of Proximal Femur and its Surgical Challenges: A Technical Note on ‘Wandering Nidus’ and Double Lesion

Epidemiology and Antibiotic Sensitivity Patterns in Pyogenic Bone and Joint Infections in Children

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Atypical Osteoid Osteoma of Proximal Femur and its Surgical Challenges: A Technical Note on ‘Wandering Nidus’ and Double Lesion

Volume 9 | Issue 1 | January-April 2023 | Page: 33-36 | Sitsabesan Chokkalingam, Arunan Murali, Roy Santhosham, Gopinath Menon

DOI- https://doi.org/10.13107/ijpo.2023.v09.i01.153

Authors: Sitsabesan Chokkalingam [1] D Ortho., Arunan Murali [2] MD Rad., Roy Santhosham [2] MD Rad., Gopinath Menon [1] MS Ortho.

[1] Department of Trauma & Orthopaedics, (SRIHER) Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, Tamil Nadu, India.
[2] Department of Radiology, (SRIHER) Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, Tamil Nadu, India.

Address of Correspondence

Dr. Sitsabesan Chokkalingam,
Department of Trauma & Orthopaedics, (SRIHER) Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, Tamil Nadu, India.
E-mail: sabesan101@gmail.com

Abstract

Introduction: Osteoid osteomas are painful benign bone tumors, accounting for 10% of overall primary bone tumors. Typical osteoid osteomas are located intracortical or intramedullary in the metadiaphyseal region of the long bones. The Atypical ones are the Juxta and Intraarticular type, posing greater challenges in its diagnosis and management. CT and MRI scans have better chances of defining the nidus lesions in Atypical osteoid osteoma of the hip joints. Surgical treatment options include, image guided percutaneous interventions such as Radio frequency ablation, Laser or Cryo ablation. These modalities achieve surgical cure, but lacks the opportunity for a histo-pathological confirmation. Our cases will highlight the ‘wandering nidus’ in hip osteoid osteoma and the possibility of dual pathology (Osteoid osteoma and Osteomyelitis) in the same hip.
Case study: We present two cases of hip joint osteoid osteomas (aged 18 yrs and 10 yrs) to highlight the diagnostic challenges and to discuss the different methodology of treatment. CT scan with additional MRI studies confirmed the radiological diagnosis after a delay of 6-8 months. The first case will highlight the wandering nature of the nidus (explained by the position of the calcific spicule within the nidus with reference to the needle tip), the challenges for needle trajectory with close proximity to femoral vessels and the “coaxial technique using chopstick maneuver” for CT guided needle excision. The second case will highlight the feasibility of percutaneous excision and surgical curettage in the presence of dual pathology.
Conclusion: Both the cases were successfully treated by CT guided n excision biopsy and had the histopathological confirmation. Needle technique allows confirmation of diagnosis and exclusion of other differential pathology.
Keywords: Wandering nidus, Atypical osteoid osteoma hip, Chopstick maneuver, Coaxial technique, Double hip lesion.

References

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How to Cite this Article: Chokkalingam S, Murali A, Santhosham R, Menon G | Atypical Osteoid Osteoma of Proximal Femur and Its Surgical Challenges: A Case Study on ‘Wandering Nidus’ and Double Lesion | International Journal of Paediatric Orthopaedics | January-April 2023; 9(1): 33-36 | https://doi.org/10.13107/ijpo.2023.v09.i01.153

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Epidemiology and Antibiotic Sensitivity Patterns in Pyogenic Bone and Joint Infections in Children

Volume 9 | Issue 1 | January-April 2023 | Page: 07-12 | Amit Sharma, G Nirmal Raj Gopinathan, Garima Sharma, Pallavi Sharma, Sange Negi

DOI- https://doi.org/10.13107/ijpo.2023.v09.i01.149

Authors: Amit Sharma [1] MS Ortho., G Nirmal Raj Gopinathan [2] MS Ortho., Garima Sharma [3] MD Microbiology, Pallavi Sharma [4] MS ObGy., Sange Negi [1] MS Ortho.

[1] Department of Orthopaedics, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India.
[2] Department of Orthopaedics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
[3] Department of Microbiology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India.
[4] Department of Obstetrics and Gynaecology, Government Medical College Hospital, Chandigarh, India.

Address of Correspondence

Dr. Garima Sharma,
Department of Microbiology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India.
E-mail: garimaserene@gmail.com

Abstract

Staphylococcus aureus is the most common organism causing paediatric bone and joint infections accounting for 86% of pus culture-positive cases. Methicillin resistant staphylococcus aureus (MRSA) has become a major challenge in the tertiary care setting as the majority (56%) of all pus culture postive cases were MRSA. The male to female ratio in these infections was approximately 2:1. The lower limbs were affected in the majority of children with osteomyelitis (OM) with hip joint being the commonest (50%) followed by the knee. Broad spectrum antibiotics were used emperically in 40% of cases prior to referral to a tertiary care centre. MRSA infections were associated with a higher likelihood of complications.
Keywords: Paediatric, Pyogenic, Bone and joint infections, Antibiotic practices

References

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How to Cite this Article: Sharma A, Gopinathan GNR, Sharma G, Sharma P, Negi S | Epidemiology and Antibiotic Sensitivity Patterns in Pyogenic Bone and Joint Infections in Children | International Journal of Paediatric Orthopaedics | January-April 2023; 9(1): 07-12 | https://doi.org/10.13107/ijpo.2023.v09.i01.149

Half Sized Blog Element (Single Author Style)

Half Sized Blog Element (Multi Author Style)

Atypical Osteoid Osteoma of Proximal Femur and its Surgical Challenges: A Technical Note on ‘Wandering Nidus’ and Double Lesion

Epidemiology and Antibiotic Sensitivity Patterns in Pyogenic Bone and Joint Infections in Children

Atypical Osteoid Osteoma of Proximal Femur and its Surgical Challenges: A Technical Note on ‘Wandering Nidus’ and Double Lesion

Epidemiology and Antibiotic Sensitivity Patterns in Pyogenic Bone and Joint Infections in Children

Full Sized Blog Element (Big Preview Pic)

Atypical Osteoid Osteoma of Proximal Femur and its Surgical Challenges: A Technical Note on ‘Wandering Nidus’ and Double Lesion

Authors: Sitsabesan Chokkalingam [1] D Ortho., Arunan Murali [2] MD Rad., Roy Santhosham [2] MD Rad., Gopinath Menon [1] MS Ortho.

Abstract

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Epidemiology and Antibiotic Sensitivity Patterns in Pyogenic Bone and Joint Infections in Children

Abstract

References

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