Orthopaedic Review, Vol. 15, pp. 301-304, 1986
Author: Robert L. Barrack, MD, Mark R. Brinker, BA, Stephen W. Burke, MD, and John M. Roberts, MD
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When excision of an osteoid osteoma in a surgically inaccessible area, such as the spine, is planned, precise preoperative localization is essential to minimize the surgical approach and ensure removal of all nidus tissue. A case is reported in which computerized tomography (CT) was particularly helpful in anatomically localizing the lesion as well as in identifying an atypical nidus.
An 8-year-old Hispanic boy presented at Children's Hospital, with a one-year history of pain in his right shoulder and neck that was worse at night and was partially relieved by aspirin. There was no previous history of trauma or infection. Physical examination revealed point tenderness to palpation of the lateral lower cervical spine on the right side. There was a mild torticollis, with the head tilted to the right, and mild limitation of neck motion in nexion, extension, and lateral bending was also noted. Plain x-rays showed a lesion of the right seventh cervical pedicle, most evident on an
oblique view (Fig I). Tomograms revealed an enlargement of the pedicle (Fig 2). Technetium
bone scan showed a localized area...