Publication:

Metachronous osteoid osteoma in adjacent proximal phalanges: a case report and literature review

Osteoid osteoma (OO) is a benign bone tumor commonly affecting long bones, and in rare cases, involves small bones such as hand phalanges. The presenting symptom is usually nocturnal inflammatory pain. OO is in the majority of cases a solitary lesion, with very rare reported cases of metachronous lesions in different locations. We present a case of a 31-year-old female patient who presented for severe pain and swelling over her fourth finger proximal interphalangeal joint (PIPJ) of the right hand. After thorough radiological investigations, a presumptive diagnosis of OO was made and the patient underwent surgical excision and curettage with resolution of her symptoms post-operatively. Six years after remission, the patient presented again to our clinics with the same clinical picture in the third finger PIPJ of the right hand. Clinical and radiological investigations revealed a metachronous OO in the adjacent phalanx of the previous surgical site. Similar management consisting of excision and curettage was performed, resulting in a symptom-free follow up. To our knowledge, this is the first case of metachronous OO in adjacent proximal phalanges of the hand. This case highlights the importance of considering metachronous OO in the differential diagnosis of patients previously diagnosed and treated for OO and presenting with a similar clinical and radiological picture.