Diagnostic Delay in Patients with Osteoid Osteoma.

Gassert, Florian Tilman; Gassert, Felix Gerhard; Hofmann, Felix Carl; Lenhart, Nicolas; Feuerriegel, Georg Constantin; von Schacky, Claudio E; Neumann, Jan; Lenze, Ulrich; Knebel, Carolin; Wörtler, Klaus

doi:10.1055/a-2203-2823

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Klinik und Poliklinik für Orthopädie und Sportorthopädie (Prof. von Eisenhart-Rothe)

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Title:: Diagnostic Delay in Patients with Osteoid Osteoma.
Document type:: Journal Article
Author(s):: Gassert, Florian Tilman; Gassert, Felix Gerhard; Hofmann, Felix Carl; Lenhart, Nicolas; Feuerriegel, Georg Constantin; von Schacky, Claudio E; Neumann, Jan; Lenze, Ulrich; Knebel, Carolin; Wörtler, Klaus
Abstract:: PURPOSE: To assess diagnostic delay in patients with osteoid osteoma and to analyze influencing factors. MATERIALS AND METHODS: All patients treated for osteoid osteoma at our tertiary referral center between December 1997 and February 2021 were retrospectively identified (n = 302). The diagnosis was verified by an expert panel of radiologists and orthopedic surgeons. The exclusion criteria were post-interventional recurrence, missing data on symptom onset, and lack of pretherapeutic CT images. Clinical parameters were retrieved from the local clinical information system. CT and MR images were assessed by a senior specialist in musculoskeletal radiology. RESULTS: After all exclusions, we studied 162 patients (mean age: 24 ± 11 years, 115 men). The average diagnostic delay was 419 ± 485 days (median: 275 days; range: 21-4503 days). Gender, patient age, presence of nocturnal pain, positive aspirin test, extent of bone sclerosis, and location of the tumor within bone and relative to joints did not influence diagnostic delay (p > 0.05). It was, however, positively correlated with nidus size (r = 0.26; p < 0.001) and was shorter with affection of long tubular bones compared to all other sites (p = 0.04). If osteoid osteoma was included in the initial differential diagnoses, the diagnostic delay was also shorter (p = 0.007). CONCLUSION: The diagnostic delay in patients with osteoid osteoma is independent of demographics, clinical parameters, and most imaging parameters. A long average delay of more than one year suggests low awareness of the disease among physicians. Patients with unclear imaging findings should thus be referred to a specialized musculoskeletal center or an expert in the field should be consulted in a timely manner. KEY POINTS: · In this retrospective study of 162 patients treated for osteoid osteoma, the median diagnostic delay was 275 days (range: 21-4503 days).. · Gender, age, presence of nocturnal pain, positive aspirin test, extent of bone sclerosis, and location of the tumor did not influence the diagnostic delay (p > 0.05).. · Diagnostic delay was positively correlated with nidus size (r = 0.26; p < 0.001) and was shorter with affection of long tubular bones compared to all other sites (376 ± 485 vs. 560 ± 462 days; p = 0.04)..
Journal title abbreviation:: Rofo
Year:: 2024
Journal volume:: 196
Journal issue:: 7
Pages contribution:: 707-713
Fulltext / DOI:: doi:10.1055/a-2203-2823
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/37995734
Print-ISSN:: 1438-9029
TUM Institution:: Institut für Diagnostische und Interventionelle Radiologie (Prof. Makowski); Klinik und Poliklinik für Orthopädie und Sportorthopädie (Prof. von Eisenhart-Rothe)
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