Computerized tomography-guided radiofrequency ablation for osteoid osteoma: preliminary results

Background Osteoid osteoma (OO) is an osteogenic bone tumor. Clinically, it is characterized by night pain that improves with NSAID treatment. It appears in radiography as a small radiolucent nidus with sclerosis of the surrounding bone. Surgical excision is the classic treatment of choice. However, many noninvasive procedures have been used to avoid the morbidity associated with surgical treatment. The aim of this study was to evaluate the efficacy of modified technique of radiofrequency ablation (RFA) in the management of OO. Patients and methods A total of 37 patients with OO were treated with percutaneous computed tomography-guided RFA. Overall, 24 lesions were located in the femur, 10 in the tibia, two in the acetabulum, and one in scapula. The diagnosis was based on clinical symptoms, radiographs, computed tomography scan, and bone scintigraphy. Bone drilling was used to make a track to reach the nidus. The average follow-up period was 37 months. Results A total of 36 patients became pain free within a period of 12 h 3 weeks after the procedure. One patient experienced a milder form of pain. One patient had transient sciatica, which improved using corticosteroids and NSAIDs. Two patients had soft tissue infection treated using antibiotics. No recurrence was reported for at least 2.5 years. Conclusions RFA is a safe and effective treatment for OO lesions, especially for lesions, which is difficult to be managed surgically. The use of a bone drill facilitates the technique and decreases the operative time.