Abstract
Presented here is a case of a young woman, with an undiagnosed osteoid osteoma of the spine, which presented with painful scoliosis in adolescence and was treated by bracing until her accession to adulthood. A more thorough investigation, years after the initial one, revealed the tumour. Surgical excision and stabilization offered the long-awaited cure. Misdiagnosis resulted in intractable pain for years, deformity, the discomfort of brace therapy, and the frustration of a prolonged yet ineffective treatment.
Background
The most common cause of painful scoliosis in adolescents is osteoid osteoma of the spine1. Up to 25% of all osteoid osteomas are found in the spine, of which 60% are located in the lumbar spine, 27% in the cervical, 12% in the thoracic and 2% on the sacrum2. There is a very strong correlation of this neoplasm with scoliosis, since two thirds of spinal osteoid osteomas manifest as painful scoliosis2. It is however extremely common for the wrong diagnosis to be initially set in a large, albeit unknown, number of cases3. The lesion is often recognised after months or years of ineffective bracing4.
Presented here is a case of a young woman, who presented with painful scoliosis in adolescence and was treated by bracing until her accession to adulthood, without the osteoid osteoma she suffered from being diagnosed. She therefore endured intractable pain for years, on top of which was added the discomfort of brace therapy. The impact of a prolonged yet ineffective treatment on the psychological status of a patient with chronic pain as well as deformity should not be overlooked.
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