Muscles, ligaments and tendons journal · 2015
Enthesopathy of the pectoralis major tendon mimicking osteoid osteoma. A case report with an unfortunate series of events.
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Baumhoer Daniel, Jundt Gernot, Lenze Ulrich, Reisinger Clemens, Hirschmann Anna
Аннотация
BACKGROUND: we present the case of an enthesopathy at the proximal humerus which was initially - due to the clinical history and a positive bone scintigraphy - regarded suspicious for metastatic breast cancer in a 50-year-old woman.
CASE REPORT: after complementing radiographs and a magnetic resonance (MR) examination exhibiting a focally contrast enhancing juxtacortical osteolysis of the humerus, a metastasis seemed radiologically unlikely, but besides a traction-related periosteal reaction of the pectoralis major tendon an unusual osteoid osteoma could not unequivocally be ruled out. Although radiological follow-up was recommended the patient insisted on a surgical resection that was performed subsequently and confirmed an enthesopathy. Shortly after, she fractured her upper arm following minor trauma but is doing well after conservative treatment since then.
CONCLUSION: enthesopathies presenting as unusual periosteal reactions can mimic primary and secondary bone tumors and should always be included in the differential diagnosis.
CASE REPORT: after complementing radiographs and a magnetic resonance (MR) examination exhibiting a focally contrast enhancing juxtacortical osteolysis of the humerus, a metastasis seemed radiologically unlikely, but besides a traction-related periosteal reaction of the pectoralis major tendon an unusual osteoid osteoma could not unequivocally be ruled out. Although radiological follow-up was recommended the patient insisted on a surgical resection that was performed subsequently and confirmed an enthesopathy. Shortly after, she fractured her upper arm following minor trauma but is doing well after conservative treatment since then.
CONCLUSION: enthesopathies presenting as unusual periosteal reactions can mimic primary and secondary bone tumors and should always be included in the differential diagnosis.