An adult man presented with a 5-month history of anterior right shoulder pain. He denied previous trauma or night pain. On the otherwise normal physical examination, pain was elicited in maximum abduction and external rotation. Radiographs were negative. The primary imaging findings were bone marrow oedema of the inferomedial proximal metaphysis of the humerus on MRI and cortical demineralisation on CT located posteromedially. A superficial elevation was also observed around the lesion. A provisional diagnosis of an osteoid osteoma was made based on these imaging findings. Arthroscopic excision of the lesion was performed, and histopathological examination confirmed the diagnosis of an osteoid osteoma. Diagnosis of intra-articular osteoid osteomas may be challenging due to atypical symptomatology and lack of pathognomonic imaging findings. Arthroscopic excision of such lesions in the shoulder is a safe and reliable option and should be considered as the treatment of choice.
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Contributors AZ and MEH were the medically responsible consultants for the presented patient. AF and VM were the medically responsible residents for the presented patient. VM completed the draft and manuscript preparation. AF completed the literature search. AK completed the image interpretation and supervised the writing and presentation of key images. DP performed the histopathological examination and supervised the presentation of the analysis in the manuscript. AZ and MEH were responsible for manuscript finalisation.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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