Diagnostic Delay in Patients with Osteoid Osteoma

Zielsetzung To assess the diagnostic delay in patients with osteoid osteoma and to analyze influencing factors.

Material und Methoden All patients treated for osteoid osteoma at our tertiary referral center between December 1997 and February 2021 were retrospectively identified (n=302). The diagnosis was verified by an expert panel of radiologists and orthopedic surgeons. Exclusion criteria were post-interventional recurrence, missing data on symptom onset, and if no CT images were available. Clinical parameters were retrieved from the local clinical information system. CT and MR images were assessed by a senior specialist in musculoskeletal radiology.

Ergebnisse After all exclusions, we studied 162 patients (115 men, 47 women) with an average age of 24±11 years. The average diagnostic delay was 419±485 days (median: 275 days; range: 21-4503 days). Gender, patient age, presence of nocturnal pain, positive Aspirin test, extent of sclerosis, and location of the tumor within bone and relative to joints did not influence diagnostic delay (p>0.05). It was, however, positively correlated with nidus size (r=0.26; p<0.001), and shorter with affection of long tubular bones compared to all other sites (p=0.04). If osteoid osteoma was included in the initial differential diagnoses, diagnostic delay was also shorter (p=0.007).

Schlussfolgerungen The diagnostic delay in patients with osteoid osteoma is independent from demographics, clinical parameters and most imaging parameters. A long average delay of more than one year suggests low awareness of the disease. Patients with unclear imaging findings should thus be referred to a specialized musculoskeletal center or an expert in the field should be consulted timely.

Publication History

Article published online:
13 April 2023