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case_images: A: Thickening of the coracoid and scapula. B: Bone marrow swelling in the coracoid, along with increased bone thickness in the front of the scapula. There was also tissue swelling and fluid in the shoulder joint. C: A typical appearance of an osteoid osteoma (nidus) in the coracoid, with thickening of the bone cortex and surrounding tissues.
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case_images: Initial X-rays showed thickening of the coracoid and scapula (Fig. 1A). An MRI revealed significant bone changes and swelling (Fig. 1B), and a CT scan showed a lesion on the base of the coracoid, suspected to be an osteoid osteoma (Fig. 1C).
case_images: Figures showing the (A) dissection region, (B) Nidus being completely isolated and separated, (C) Removed Tissue of the Osteoid Osteoma.
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case_images: The surgeon performed an ostectomy at the base of the coracoid, where the lesion (nidus) was located and completely removed (Fig. 2).
case_images: (A) Sharp border (orange line) of nidus and surrounding bone: Thickened trabeculae of lamellar bone (left) and trabeculae of woven bone with prominent osteoblastic rimming (right) (4x) (B) Nidus consists woven bone trabeculae of variable thickness lined by prominent osteoblastic rimming and intervening fibrovascular stroma (10x). (C) High power view of variable mineralized woven bone trabeculae and a single layer of plump osteoblastic rim. Scattered giant cells (arrows) are present within fibrovascular stroma (40x).
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case_images: Additionally, thicker lamellar bone was found along with loose fibrovascular tissue (Fig. 3).
case_images: Pain free complete range of motion in last follow-up.
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case_images: At follow-up visits at 1, 3, 6, 12, and 24 months, the patient had no pain or recurrence of the condition and no reported limited range of motion was detected. (Fig. 4, Fig. 5).