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“Occult” Roentgenographic Osteoblastoma of the Cervical Spine

LaBan, Myron M. MD, MMSc; Riutta, Justin C. MD

American Journal of Physical Medicine & Rehabilitation: October 2003 - Volume 82 - Issue 10 - p 820-823
doi: 10.1097/01.PHM.0000087457.02231.FE
Case Reports: Neck Pain
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LaBan MM, Riutta JC: “Occult” roentgenographic osteoblastoma of the cervical spine. Am J Phys Med Rehabil 2003;82:820–823.

A 33-yr-old man presented with a 4-yr history of neck pain. Previous work-ups, including planar radiographs and magnetic resonance imaging, were determined as “normal” by six previous consultants. In a subsequent in-office evaluation by a physiatrist, a vertebral osteoid osteoma or carotid artery angiitis was clinically suspected. A bone scan of the cervical spine was consistent with a the presence of an of osteoid osteoma. Thereafter, repeat magnetic resonance imaging confused the issue by suggesting the presence osteomyelitis involving the C3-C4 facet joint. Spiral cervical spine computed tomography with digital reconstruction once again demonstrated the presence of an osteoblastoma. The patient was subsequently referred to a spinal surgeon for biopsy and resection, which confirmed the presence of an osteoblastoma. Although benign cervical neoplasms presenting as neck pain occur most often in a pediatric population, at any age, the differential diagnosis of intractable neck pain should include the possibility of a primary osseous or metastatic tumor.

From the Department of Physical Medicine and Rehabilitation, William Beaumont Hospital, Royal Oak, Michigan.

All correspondence and requests for reprints should be addressed to Myron M. LaBan, MD, MMSc, Department of Physical Medicine and Rehabilitation, William Beaumont Hospital, 3601 West Thirteen Mile Road, Royal Oak, MI 48073.

© 2003 Lippincott Williams & Wilkins, Inc.