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Medical management of osteoid osteoma
1Department of Orthopedics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
Objective:
To see if the results of managing osteoid osteoma with medical treatment alone is comparable to those after surgery or other ablative therapy.
Design:
A case series.
Setting:
A tertiary care centre.
Patients:
Eleven patients with osteoid osteoma treated over a 5-year period. The condition was diagnosed from a typical history, patient age, standard radiography, computed tomography, bone scanning, complete blood count and measurement of the erythrocyte sedimentation rate.
Interventions:
Continued medical treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) for 6 months after pain ceased. Surgery was done only in those who refused or could not tolerate medical treatment.
Main Results:
Medical treatment successfully controlled the pain in all patients. Two patients decided to undergo surgery because of intolerance to the NSAIDS. In 7 patients the symptoms resolved after a mean time of 2.5 years. Two patients were still taking NSAIDS 5 years from the time of diagnosis.
Conclusions:
The natural history of osteoid osteoma is self-limited so patients should be offered nonoperative treatment, reserving ablative treatment for those who are unable or unwilling to take NSAIDs until their symptoms resolve.