Osteoid Osteoma in the Lamina of the Lumbar Spine: A Case Report. Value of MR imaging.:Value of MR imaging

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Osteoid osteoma is an osteoblastic tumor consisting of a discrete "nidus" of tightly interlacing trabeculae of osteoid. However, it is not easy to locate the tumor nidus or make an early diagnosis by radiography.Recently, we have experienced and treated an osteoid osteoma of the spine in a 22-year-old man. The preoperative computed tomography scan demonstrated a rounded area of osteolysis with small area of calcification within the nidus and intense perifocal sclerotic thickening in the right half of the lamina of the fourth lumbar spine. The magnetic resonance imaging (MRI) showed indistinct areas of increased signal intensity in the soft tissues on T2-weighted images, which were outside the actual tumor exfending into these structures, and showed indistinct areas of decreased signal intensity in the marrow of the involved bone beyond the well-defined tumor margin on T1-weighted images. These changes indicate edema, e. g., inflammatory changes on MRI. Care must be taken in interpretation of MRI in disorders in which secondary bone marrow changes occur to avoid erroneous diagnoses and possible incorrect operative procedures.