Bruschi A1*, Boriani L1, Spinnato P2, Facchini G2 and Gasbarrini A1
1Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Italy 2Department of Radiology, IRCCS Istituto Ortopedico Rizzoli, ItalyFulltext PDF
Spine osteoid osteoma can be a challenging diagnosis. Radiating pain to thorax, abdomen or thigh due to radiculopathy is known to mislead diagnostic path to non-orthopedic conditions. This is cause of delayed diagnoses and treatments. So, osteoid osteoma should be considered when a nocturnal recurrent pain finds no diagnostic resolution. Abdominal neuro-vegetative symptoms have never been described as cause of misdiagnosis in spine osteoid osteoma. This a case of a 17 years old girl with recurrent nocturnal back pain with epigastric discomfort and nausea due to a D12 spine osteoid osteoma. The patient underwent a 12 months diagnostic path for internal or gynecological causes of abdominal pain before reaching the correct diagnosis. Bone scintigraphy and thin slices (0.2 mm) CT scan revealed the spine osteoid osteoma in the left articular process of D12 confirmed by histology. CT guided radiofrequency of the lesion lead to a resolution of symptoms. Nocturnal recurrent pain and painful scoliosis should raise the suspicion of spine osteoid osteoma. As shown in this case, even in the absence of radiculopathy, neuro-vegetative symptoms can be present and can be misdiagnosed with abdominal pain.
Bruschi A, Boriani L, Gasbarrini A. Epigastric Discomfort and Nausea in Spine Osteoid Osteoma: A Case Report of Neuro-Vegetative Symptoms Bringing to an Elusive Diagnosis. Ann Clin Case Rep. 2021; 6: 2055. ISSN: 2474-1655.