After three days, the patient underwent a scan. Upon emerging, the technician informed her that her doctor would be contacting her.
The M.R.I. revealed something concerning, according to Smith. It was a tumor, but she believed it was not malignant. To confirm, the patient would need a CT scan. Smith explained that she suspected the young woman had an osteoid osteoma, an inflammatory tumor common in people her age. However, the M.R.I. was not the ideal diagnostic tool for this case. The patient took a look at the M.R.I. report in her electronic medical record and found it alarming. Along with the small tumor, the report listed more worrisome possibilities, including cancer and bone infections. The benign tumor that Smith suspected wasn’t mentioned at all.
The CT scan was fortunately quick, and Smith promptly called with the diagnosis: It was indeed an osteoid osteoma. Although these tumors typically disappear on their own after a few years, most individuals opt to have them removed due to their intense pain. The treatment involves introducing a tiny catheter to the tumor under CT guidance and applying heat with a probe. Since the procedure is painful, general anesthesia is usually administered.
Smith shared that she had encountered three patients with osteoid osteomas, each time discovering it while searching for a different ailment. This tumor is known as the great mimicker since it closely resembles many other more common or dangerous conditions.
The patient decided to delay the procedure until after her time abroad during the semester. However, she ultimately underwent the operation at the beginning of Hanukkah. After the pain medication from the hospital wore off, her hip became immensely painful. Her parents advised against using the prescribed opiates, so she managed the pain with ibuprofen and acetaminophen during her first week at home. By the second week, she was feeling better. She considered herself fortunate, especially because her parents were doctors who knew how to navigate the system and get her the necessary specialists and tests. Even so, it took two years to reach a diagnosis. She acknowledged that it must be significantly more challenging for those without such advantages.
Lisa Sanders, M.D., is a contributing writer for the magazine. Her latest book is “Diagnosis: Solving the Most Baffling Medical Mysteries.” If you have a solved case to share, you can contact her at [email protected].
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