Avoiding Misdiagnosis and Missed Diagnosis for Appropriately Treating Spinal Osteoid Osteomas: A Single‐Center Experience

Objectives To analyze the causes of misdiagnosis and missed diagnosis in spinal osteoid osteoma, and to put forward solutions to improve diagnosis accuracy and treatment efficacy in patients. Methods We performed a retrospective cohort study on patients with spinal osteoid osteoma in Beijing Jishuit...

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Main Authors: Qiming Xu, Wensheng Liu, Hairong Xu, Lijia Cui, Yuan Li, Huachao Shan, Zhen Huang, Ke Ma, Xiaohui Niu
Format: Article
Language:English
Published: Wiley 2022-05-01
Series:Orthopaedic Surgery
Subjects:
Online Access:https://doi.org/10.1111/os.13280
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author Qiming Xu
Wensheng Liu
Hairong Xu
Lijia Cui
Yuan Li
Huachao Shan
Zhen Huang
Ke Ma
Xiaohui Niu
author_facet Qiming Xu
Wensheng Liu
Hairong Xu
Lijia Cui
Yuan Li
Huachao Shan
Zhen Huang
Ke Ma
Xiaohui Niu
author_sort Qiming Xu
collection DOAJ
description Objectives To analyze the causes of misdiagnosis and missed diagnosis in spinal osteoid osteoma, and to put forward solutions to improve diagnosis accuracy and treatment efficacy in patients. Methods We performed a retrospective cohort study on patients with spinal osteoid osteoma in Beijing Jishuitan Hospital from January 1983 to September 2019. All patients underwent surgery. The outcome measures were the extent of local pain, nocturnal pain, radicular symptoms of extremities after surgery, and reduction or disappearance of lesions on CT after surgery. Results Thirty‐seven patients with spinal osteoid osteoma were recruited in the study. A total of 27% were female, and the mean (SD) age at diagnosis was 21.3 (8.7) years. A total of 87.0% of patients presented with nocturnal pain, and 94.7% of patients were responsive to NSAIDS treatment. The mean (SD) time from the initial onset of symptoms to the final diagnosis was 14.7 (12.5) months. Only four of 37 (10.8%) patients were correctly diagnosed with spinal osteoid osteoma on the first visit to the local hospital. CT is associated with a higher diagnosis rate than X‐ray or MRI on the first visit. Surgical navigation was used in 88.9% of patients who underwent curettage resection, and in 10% of patients who underwent en bloc resection. A total of 37 of 37 patients (100%) reported relief of local pain and radicular symptoms of extremities after surgery, and no recurrence of tumors was found during follow‐ups. Conclusions Spinal CTs are recommended to be performed if osteoid osteoma is suspected based on clinical manifestation, including nocturnal pain and responsiveness to NSAIDS treatment, to avoid misdiagnosis and missed diagnosis of spinal osteoid osteoma.
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spelling doaj.art-aec9b53ccec24a798ab614559a044bda2022-12-22T02:23:29ZengWileyOrthopaedic Surgery1757-78531757-78612022-05-0114586887510.1111/os.13280Avoiding Misdiagnosis and Missed Diagnosis for Appropriately Treating Spinal Osteoid Osteomas: A Single‐Center ExperienceQiming Xu0Wensheng Liu1Hairong Xu2Lijia Cui3Yuan Li4Huachao Shan5Zhen Huang6Ke Ma7Xiaohui Niu8Department of Orthopaedic Oncology Beijing Jishuitan Hospital Beijing ChinaDepartment of Orthopaedic Oncology Beijing Jishuitan Hospital Beijing ChinaDepartment of Orthopaedic Oncology Beijing Jishuitan Hospital Beijing ChinaDepartment of Endocrinology Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Key Laboratory of Endocrinology, National Health Commission Beijing ChinaDepartment of Orthopaedic Oncology Beijing Jishuitan Hospital Beijing ChinaDepartment of Orthopaedic Oncology Beijing Jishuitan Hospital Beijing ChinaDepartment of Orthopaedic Oncology Beijing Jishuitan Hospital Beijing ChinaDepartment of Orthopaedic Oncology Beijing Jishuitan Hospital Beijing ChinaDepartment of Orthopaedic Oncology Beijing Jishuitan Hospital Beijing ChinaObjectives To analyze the causes of misdiagnosis and missed diagnosis in spinal osteoid osteoma, and to put forward solutions to improve diagnosis accuracy and treatment efficacy in patients. Methods We performed a retrospective cohort study on patients with spinal osteoid osteoma in Beijing Jishuitan Hospital from January 1983 to September 2019. All patients underwent surgery. The outcome measures were the extent of local pain, nocturnal pain, radicular symptoms of extremities after surgery, and reduction or disappearance of lesions on CT after surgery. Results Thirty‐seven patients with spinal osteoid osteoma were recruited in the study. A total of 27% were female, and the mean (SD) age at diagnosis was 21.3 (8.7) years. A total of 87.0% of patients presented with nocturnal pain, and 94.7% of patients were responsive to NSAIDS treatment. The mean (SD) time from the initial onset of symptoms to the final diagnosis was 14.7 (12.5) months. Only four of 37 (10.8%) patients were correctly diagnosed with spinal osteoid osteoma on the first visit to the local hospital. CT is associated with a higher diagnosis rate than X‐ray or MRI on the first visit. Surgical navigation was used in 88.9% of patients who underwent curettage resection, and in 10% of patients who underwent en bloc resection. A total of 37 of 37 patients (100%) reported relief of local pain and radicular symptoms of extremities after surgery, and no recurrence of tumors was found during follow‐ups. Conclusions Spinal CTs are recommended to be performed if osteoid osteoma is suspected based on clinical manifestation, including nocturnal pain and responsiveness to NSAIDS treatment, to avoid misdiagnosis and missed diagnosis of spinal osteoid osteoma.https://doi.org/10.1111/os.13280MisdiagnosisMissed diagnosisOsteoid osteomaSpineSurgery
spellingShingle Qiming Xu
Wensheng Liu
Hairong Xu
Lijia Cui
Yuan Li
Huachao Shan
Zhen Huang
Ke Ma
Xiaohui Niu
Avoiding Misdiagnosis and Missed Diagnosis for Appropriately Treating Spinal Osteoid Osteomas: A Single‐Center Experience
Orthopaedic Surgery
Misdiagnosis
Missed diagnosis
Osteoid osteoma
Spine
Surgery
title Avoiding Misdiagnosis and Missed Diagnosis for Appropriately Treating Spinal Osteoid Osteomas: A Single‐Center Experience
title_full Avoiding Misdiagnosis and Missed Diagnosis for Appropriately Treating Spinal Osteoid Osteomas: A Single‐Center Experience
title_fullStr Avoiding Misdiagnosis and Missed Diagnosis for Appropriately Treating Spinal Osteoid Osteomas: A Single‐Center Experience
title_full_unstemmed Avoiding Misdiagnosis and Missed Diagnosis for Appropriately Treating Spinal Osteoid Osteomas: A Single‐Center Experience
title_short Avoiding Misdiagnosis and Missed Diagnosis for Appropriately Treating Spinal Osteoid Osteomas: A Single‐Center Experience
title_sort avoiding misdiagnosis and missed diagnosis for appropriately treating spinal osteoid osteomas a single center experience
topic Misdiagnosis
Missed diagnosis
Osteoid osteoma
Spine
Surgery
url https://doi.org/10.1111/os.13280
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