Cámara FMM, Alejos GR, Amaya-Aguilar F, Méndez-Domínguez N

Language: Spanish
References: 17
Page: 1-10
PDF size: 427.12 Kb.

ABSTRACT

Femoroacetabular impingement generates acute pain in the anterior groin and limitation of hip mobility. It is a clinical syndrome caused by an alteration in bone anatomy. Osteochondromas are the main types of benign tumors, they alter the bone anatomy and depending on their location, they can generate pain and impingement. This case report aims to serve as a reference for specialized care in communicating the diagnostic challenges and approach in a patient with secondary clamping to osteochondroma of atypical presentation. The present case report aims to describe the given treatment and clinical evolution of a patients presenting femoroacetabular impingement secondary to a solitary osteochondroma. We report a 20-year-old male patient with exacerbation of a shooting pain and decrease in the mobility arches in his right hip joint, with no improvement with symptomatic treatment. Through imaging studies, a tumor mass was identified in the affected region. Total surgical resection was performed through an extended direct lateral approach of Hardinge. Given the benign nature of the tumor and its total resection, the patient evolved satisfactorily. The prognosis is favorable. He was able to return to his daily activities. We concluded that osteochondromas are not exclusive to the metaphysis or epiphyses of long bones. Atypical presentations should be suspected when clinical manifestations suggest so, even after adolescence.

REFERENCES

1. Ghaffari A, Davis I, Storey T, Moser M. Current Concepts of Femoroacetabular Impingement. Radiol Clin North Am. 2018;56(6):965-82. doi: 10.1016/j.rcl.2018.06.009 2. Bedi A, Kelly BT. Femoroacetabular impingement. J Bone Joint Surg Am. 2013;95(1):82-92. doi: 10.2106/JBJS.K.01219

2. Clohisy JC, Knaus ER, Hunt DM, Lesher JM, Harris-Hayes M, Prather H. Clinical presentation of patients with symptomatic anterior hip impingement. Clin Orthop Relat Res. 2009;467(9):638-44. doi: 10.1007/s11999-008-0680-y

3. Dick AG, Houghton JM, Bankes MJK. An approach to hip pain in a young adult. BMJ. 2018;19;361:k1086. doi: 10.1136/bmj.k1086

4. Amanatullah DF, Antkowiak T, Pillay K, Patel J, Refaat M, Toupadakis CA, et al. Femoroacetabular impingement: current concepts in diagnosis and treatment. Orthopedics. 2015;38(3):185-99. doi: 10.3928/01477447-20150305-07

5. Leunig M, Beaulé PE, Ganz R. The concept of femoroacetabular impingement: currentstatus and future perspectives. Clin Orthop Relat Res. 2009;467(3):616-22. doi: 10.1007/s11999-008-0646-0

6. Fletcher CDM, Unni KK, Merteus F. World Health Organization: Classification of tumours. Pathology and genetics of tumours of soft tissue and bone. Lyon: IARC Press; 2002. ISBN: 9789283224136

7. Hill CE, Boyce L, Van der Ploeg ID. Spontaneous resolution of a solitary osteochondroma of the distal femur: a case report and review of the literature. J Pediatr Orthop B. 2014;23(1):73-5. doi: 10.1097/BPB.0000000000000010

8. Kitsoulis P, Galani V, Stefanaki K, Paraskevas G, Karatzias G, Agnantis NJ, et al. Osteochondromas: review of the clinical, radiological and pathological features. In Vivo. 2008;22(5):633-46. PMID: 18853760

9. Kushner BH, Roberts SS, Friedman DN, Kuk D, Ostrovnaya I, Modak S, et al. Osteochondroma in Long-Term Survivor of High-Risk Neuroblastoma. Cancer. 2015;121(12):2090-96. doi: 10.1002/cncr.29316

10. Ramos LR, Sánchez S, Casas P, Mora M, Izquierdo FM. Osteocondromas del extremo proximal del húmero. Manejo diagnóstico y terapéutico. Rev Esp Cir Ortop Traumatol. 2018;62(3):168-77. doi: 10.1016/j.recot.2017.12.003 12. Dorfman HD, Czerniak B. Bone tumors. St. Louis, MO: Mosby Inc.; 1998. p. 331-33. ISBN: 9780323091596

11. Boyacioğlu K, Kayalar N, Sarioğlu S, Yildizhan I, Mert B, Erentuğ V. Popliteal artery pseudoaneurysm associated with solitary osteochondromatosis. Vascular. 2014;22(4):286-89. doi: 10.1177/1708538113486784

12. Fukushi R, Emori M, Iesato N, Kano M, Yamashita T. Osteochondroma causing cervical spinal cord compression. Skeletal Radiol. 2017;46(8):1125-30. doi: 10.1007/s00256-017-2633-6

13. Czajka CM, DiCaprio MR. What is the proportion of patients with multiple hereditary exostoses who undergo malignant degeneration? Clin Orthop Relat Res. 2015;473(7):2355-61. doi: 10.1007/s11999-015-4134-z

14. Kose O, Ertas A, Celiktas M, Kisin B. Fracture of an osteochondroma treated successfully with total excision: two case reports. Cases J. 2009;2:8062. doi: 10.4076/1757-1626-2-8062

15. Gökkuş K, Atmaca H, Sağtaş E, Saylık M, Aydın AT. Osteochondromas originating from unusual locations complicating orthopedic discipline: case series. Eklem Hastalik Cerrahis. 2015;26(2):100-9. doi: 10.5606/ehc.2015.21 18. Chun YS, Rhyu KH, Cho KY, Cho YJ, Lee CS, Han CS. Osteochondroma Arising from Anterior Inferior Iliac Spine as a Cause of Snapping Hip. Clin Orthop Surg. 2016;8(1):123-6. doi: 10.4055/cios.2016.8.1.123

16. Hussain W, Avedian R, Terry M, Peabody T. Solitary osteochondroma of the proximal femur and femoral acetabular impingement. Orthopedics. 2010;33(1):51. doi: 10.3928/01477447-20091124-21

17. Sánchez PA, Arbeláez WR. Abordaje lateral indirecto modificado en artroplastia de cadera. Rev Col de Ort Tra. 2006;20(3):24-4. ISSN: 2256-490X