A 28-year-old man presented with pain and swelling in the ulnar edge of his right hand for one year.
She had no history of trauma.
The pain was spontaneous and its onset was progressive.
The pain that initially ceased with NSAI had increased along with swelling in the last weeks prior to consultation.
Physical examination revealed a poorly defined swelling at the cubital edge of the hypotenar eminence, very painful to pressure.
There was no redness or increase in local heat.
The mobility of the wrist and fingers was preserved.
A plain radiograph showed a rounded radiolucent bone lesion of eccentric location at the distal base of the hamate and a slight increase in joint space between the hamate and the pyramidal.
The study was completed with bone scintigraphy, CT and MRI.
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Three-phase bone scintigraphy performed with 99m edifice showed an intense focus of hypercaptation in the cubital region of the neck.
Similarly, Galio 67 showed a lower intensity but more extensive focal uptake.
The diagnostic impression was that the bone lesion had high osteogenic and inflammatory activity in the melanoma.
CT scan showed a rounded lytic image of 8 x 8 x 7 mm (anteroposterior diameter, transverse diameter and caudal skull) with calcification inside and edge well defined continuity fracture relationship with a solution image.
Magnetic resonance imaging showed the presence of pathological endomedullary bone edema in the hamate bone and a spherical lesion of about 8 mm in diameter located in the dorsocubital region of its distal base with a sclerotic limit.
A dorsocubital approach was performed on the distal insertion of the posterior cubital tendon, which was disinserted from the base of the fifth metatarsal.
An exhaustive curettage of the lesion and filling of the defect with spongy bone of the iliac crest was performed.
The wound was closed after transosseous reinsertion of the posterior cubital tendon.
The wrist was immobilized with a plaster splint for three weeks and another three.
The anatomopathological report described the presence of a benign mesenchymal neoformation of nature osteitis that shows an expansive growth and consists of bone trabeculae of small and irregular reticular bone.
Around these trabeculae layers are available without cytological atypia or signs of mitosis.
There is presence of multinucleated giant cells of the osteoclastic type intermingled with capillary vesicles, a rich vascular network and frequent foci of hemorrhage.
The tumor is not located in the adjacent lamellar bone.
It was diagnosed as classic osteoblastoma.
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After postoperative immobilization, the patient required rehabilitation treatment until recovery of complete wrist mobility, which was achieved at the third month.
Pain improved from the immediate postoperative period and completely resolved in the review to the third month.
In the last review, performed 4 years after surgery, the mobility of the wrist was complete and painless, and in the X-ray there was a correct incorporation of the graft, recurrence of the articular space between the pyramide.
