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Published on: March 7, 2011
Radiofrequency ablation of osteoid osteoma in atypical locations: a case series
Shahram Akhlaghpoor1, Alireza Aziz Ahari, Abbas Arjmand Shabestari
1Noor Medical Imaging Center, Shahid Yousefian St, Motahari St, Tehran, Iran. akhlaghpoor@nmri-ir.com
Background:
Osteoid osteoma has a nidus surrounded by sclerotic bone with a size usually less than 20 mm. Its diagnosis is made on typical presentation of nocturnal pain and imaging findings. Excision of the niduses, which are often small and difficult to precisely identify, sometimes may result in resection of surrounding normal bone. Minimally invasive percutaneous treatments have been used to try to minimize resection of normal bone. Although minimally invasive radiofrequency ablation generally relieves pain, its ability to relieve pain is less well known in locations other than lower extremity long bones.
Questions/Purposes:
We determined the pain relief and complication rates after radiofrequency ablation of osteoid osteomas presenting in atypical locations and followed patients to assess possible recurrence or late complications.
Patients And Methods:
We retrospectively reviewed 21 patients with osteoid osteomas in unusual locations (eg, hip, radioulnar joint, and proximal phalanx) in whom we used radiofrequency ablation. Postoperative activities were not restricted for any of the patients. We assessed the time for patients to become symptom free, their activity status, and possible recurrence or complications. The minimum clinical followup was 12 months (mean, 27.8 months; range, 12-37 months).
Results:
All patients became symptom free within 24 hours to 1 week. During followup, none of the patients experienced recurrence or any major complications.
Conclusions:
Radiofrequency ablation for osteoid osteomas in unusual locations reliably relieves pain with few complications and recurrences at short-term followup.
Level Of Evidence:
Level IV, case series. See Guidelines for Authors for a complete description of level of evidence.
Insights
Radiofrequency ablation effectively treats osteoid osteomas in unusual locations, offering rapid pain relief with minimal complications. This minimally invasive procedure provides a safe and reliable option for patients experiencing persistent pain from these bone tumors.
Area of Science:
- Orthopedic Surgery
- Interventional Radiology
- Musculoskeletal Oncology
Background:
- Osteoid osteomas are benign bone tumors characterized by a nidus and surrounding sclerosis, typically causing nocturnal pain.
- Traditional surgical excision risks damaging healthy bone due to the small size and deep location of the nidus.
- Minimally invasive techniques, like radiofrequency ablation (RFA), aim to reduce morbidity associated with osteoid osteoma treatment.
Observation:
- This study evaluated the efficacy of RFA for osteoid osteomas in atypical locations, including the hip, radioulnar joint, and proximal phalanx.
- Twenty-one patients with osteoid osteomas in unusual sites underwent RFA, with no postoperative activity restrictions.
- Patient outcomes were assessed for pain relief, symptom duration, activity status, recurrence, and late complications over a mean follow-up of 27.8 months.
Findings:
- All patients achieved complete symptom relief within one week of radiofrequency ablation.
- No instances of tumor recurrence or significant complications were observed during the follow-up period.
- Radiofrequency ablation demonstrated a high success rate in pain management for osteoid osteomas in challenging anatomical locations.
Implications:
- Radiofrequency ablation is a safe and effective treatment for osteoid osteomas, even when located in atypical anatomical sites.
- This minimally invasive approach offers a reliable alternative to surgery, minimizing damage to surrounding healthy bone.
- The findings support the expanded use of radiofrequency ablation for osteoid osteomas beyond the lower extremities.