Pearls & Oy-sters: Osteoid osteoma of the scapula masquerading as neuralgic amyotrophy

This is the authors' abstract. We don't add key points for this paper.

Osteoid osteoma is a benign bone tumor that usually presents in children and young adults characterized by local pain which is worse at night; occasionally the pain is referred to a site distant from the actual lesion.• Osteoid osteoma of the scapula should be considered in the differential diagnosis of neuralgic amyotrophy due to shared clinical features of pain, weakness, and atrophy around the shoulder and upper arm.• Osteoid osteoma is often amenable to cure by minimally invasive procedures particularly in locations like the scapula and pelvis where open surgical procedures could lead to significant complications. OY-STER• The diagnosis of osteoid osteoma may be delayed by months to years in children due to young age, focal neurologic symptoms and signs, and absence of characteristic findings on radiologic examination at an early stage.CASE REPORT A 7-year-old previously healthy right-handed boy presented to the pediatric neurology clinic with right arm and shoulder pain of 4 months duration.The pain was severe in nature, could last for an hour, at times woke him up from sleep, and was partially relieved with acetaminophen and ibuprofen.About 4 weeks prior to presentation, his parents noticed that his right upper arm was thinner than the left.The patient denied any sensory loss or weakness of the right arm or other limbs.There was no history of recent trauma or immunizations.His birth and developmental history were unremarkable and there was no family history of neuromuscular disorders.On clinical examination, his higher mental function and cranial nerves were normal.Motor system examination revealed atrophy of the right upper arm.There was no shoulder drooping, scapular winging, wasting of the forearm and hand,