spine

Osteoblastoma

Epidemiology

 

Uncommon

 

< 1% Primary bone tumour

 

Young boys

- second decade

 

Location

 

Similar to OO

 

Spine 30%

- especially posterior elements

 

Long bones 35%

 

Clinical

 

Back or limb pain

- pain less severe than OO

Biopsy Anatomical Approach

Region specific approaches

 

Theory

- want to traverse one muscle / one compartment

- keep away from NV bundle

- as a rule perform open biopsy through compartment the tumour is in

- this is the compartment that will require surgical removal in wide excision

- direct approach without going through muscle if possible i.e. tibia, distal ulna

 

Lower Limb

 

Thigh

 

Inflammatory Arthopathies

Gout

 

No pathognomonic signs for gout

- identification of negative birefringent crystals under polarising light 

- trial of indomethacin if suspected

 

Inflammatory Bowel Disease / Enteropathic

 

Crohn's & Ulcerative Colitis

- spinal manifestation similar to Ankylosing Spondylitis

- 15-60% of IBD

 

Two different forms

- mild & asymptomatic

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