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The British Journal of Radiology Oct 2020Osteoid osteoma is a painful benign bone tumour of children and young adults with characteristic clinico-radiological features depending upon the location of the lesion.... (Review)
Review
Osteoid osteoma is a painful benign bone tumour of children and young adults with characteristic clinico-radiological features depending upon the location of the lesion. Intraoperative visualisation of the nidus is difficult and therefore curative surgery is often associated with excessive bone removal, significant perioperative morbidity and potential need of bone grafting procedures. With advancement in cross-sectional imaging and radiofrequency ablation (RFA) technology, CT-guided RFA has emerged as the treatment of choice for the osteoid osteoma. This procedure involves accurate cannulation of the nidus and subsequent thermocoagulation-induced necrosis.Multidisciplinary management approach is the standard of care for patients with osteoid osteoma. Appropriate patient selection, identification of imaging pitfalls, pre-anaesthetic evaluation and a protocol-based interventional approach are the cornerstone for a favourable outcome. Comprehensive patient preparation with proper patient position and insulation is important to prevent complications. Use of spinal needle-guided placement of introducer needle, namely, "rail-road technique" is associated with fewer needle trajectory modifications, reduced radiation dose and patient morbidity and less intervention time. Certain other procedural modifications are employed in special situations, for example, intra-articular osteoid osteoma and osteoid osteoma of the subcutaneous bone in order to reduce complications. Treatment follow-up generally includes radiographic assessment and evaluation of pain score. Dynamic contrast-enhanced MRI has been recently found useful for demonstrating post-RFA healing.
Topics: Bone Neoplasms; Catheter Ablation; Humans; Osteoma, Osteoid; Radio Waves; Surgery, Computer-Assisted; Tomography, X-Ray Computed
PubMed: 32520586
DOI: 10.1259/bjr.20200266 -
The Journal of Emergency Medicine Mar 2017
Topics: Adult; Female; Humans; Mandible; Osteoma, Osteoid; Pain; Tomography, X-Ray Computed
PubMed: 27856024
DOI: 10.1016/j.jemermed.2016.10.003 -
Journal of Clinical Medicine Apr 2023Osteoid osteoma (OO) is a common benign bone tumour, usually affecting young people. Typically, it is localised to the diaphyses or metaphyses of long bones. The... (Review)
Review
Osteoid osteoma (OO) is a common benign bone tumour, usually affecting young people. Typically, it is localised to the diaphyses or metaphyses of long bones. The classical manifestation includes distinctive night pain, almost always present, responding well to non-steroidal anti-inflammatory drugs, sometimes accompanied by complaints due to physical activity, and a typical picture on additional tests. A characteristic of osteoid osteoma is the presence of a nidus, usually visible on imaging tests. The nidus generally presents as a single, round lytic lesion up to 1 cm in diameter, surrounded by an area of reactive ossification. However, OO is a multifaceted neoplasm, and its diagnosis can cause numerous difficulties. OO can mimic multiple diseases and vice versa, which often leads to a prolonged diagnostic and therapeutic path and associated complications. There are few literature reviews about the differentiation and diagnostic difficulties of osteoid osteoma. Very effective therapies for this tumour are known, such as ablation and resection. Enhanced detection of osteoid osteoma could result in faster diagnosis and less suffering for the patient, avoidance of complications, and reduced costs of incorrect and prolonged treatment.
PubMed: 37048803
DOI: 10.3390/jcm12072721 -
Seminars in Ultrasound, CT, and MR Oct 2020Osteoid osteoma (OO) is a benign bone neoplasm consisting of a central prostaglandin-secreting nidus surrounded by a zone of reactive sclerosis. The diagnosis is... (Review)
Review
Osteoid osteoma (OO) is a benign bone neoplasm consisting of a central prostaglandin-secreting nidus surrounded by a zone of reactive sclerosis. The diagnosis is suspected in children and young adults with longstanding nighttime pain that is relieved by salicylates or nonsteroidal anti-inflammatory drugs. Early studies suggested that computed tomography had a higher sensitivity and specificity in the diagnosis of OO compared to magnetic resonance imaging (MRI). More recent literature suggests MRI done with dynamic postcontrast imaging to be equal to or slightly better at detecting the nidus of OOs, particularly the ones in atypical locations. Being able to evaluate for OO utilizing MRI is important given that the majority of these lesions occur in younger patients, in whom there is greater concern to limit ionizing radiation. Furthermore, patients with atypical OOs often receive an MRI if radiographs are not suggestive of the diagnosis. Therefore, it is important for radiologists to be aware of the imaging features that can help make the diagnosis on MRI.
Topics: Adolescent; Bone Neoplasms; Bone and Bones; Child; Child, Preschool; Female; Humans; Magnetic Resonance Imaging; Male; Osteoma, Osteoid
PubMed: 32980095
DOI: 10.1053/j.sult.2020.05.013 -
Wiener Klinische Wochenschrift Jun 2022Osteoid osteomas of the foot are rare, with a varying and atypical clinical as well as radiological presentation impeding early diagnosis and treatment. The aim of the...
BACKGROUND
Osteoid osteomas of the foot are rare, with a varying and atypical clinical as well as radiological presentation impeding early diagnosis and treatment. The aim of the present multicentre study was to 1) analyze epidemiological, clinical and radiological findings of patients with foot osteoid osteomas and to 2) deduce a diagnostic algorithm based on the findings.
METHODS
A total of 37 patients (25 males, 67.6%, mean age 23.9 years, range 8-57 years) with osteoid osteomas of the foot were retrospectively included, treated between 2000 and 2014 at 6 participating tertiary tumor centres. Radiographic images were analyzed, as were patients' minor and major complaints, pain relief and recurrence.
RESULTS
Most osteoid osteomas were located in the midfoot (n = 16) and hindfoot (n = 14). Painful lesions were present in all but one patient (97.3%). Symptom duration was similar for hindfoot and midfoot/forefoot (p = 0.331). Cortical lesions required fewer x‑rays for diagnosis than lesions at other sites (p = 0.026). A typical nidus could be detected in only 23/37 of x‑rays (62.2%), compared to 25/29 CT scans (86.2%) and 11/22 MRIs (50%). Aspirin test was positive in 18/20 patients (90%), 31 patients (83.8%) underwent open surgery. Pain relief was achieved in 34/36 patients (outcome unknown in one), whilst pain persisted in two patients with later confirmed recurrence.
CONCLUSIONS
As previously reported, CT scans seem to be superior to MRIs towards detection of the typical nidus in foot osteoid osteomas. In patients with unclear pain of the foot and inconclusive x‑rays, osteoid osteoma should be considered as differential diagnosis.
Topics: Adolescent; Adult; Bone Neoplasms; Child; Humans; Male; Middle Aged; Osteoma, Osteoid; Pain; Retrospective Studies; Treatment Outcome; Young Adult
PubMed: 34735614
DOI: 10.1007/s00508-021-01966-0 -
Surgical Oncology May 2022We sought to systematically assess and summarize the available literature on the clinical outcomes and complications following radiofrequency ablation (RFA) for painful... (Review)
Review
AIM
We sought to systematically assess and summarize the available literature on the clinical outcomes and complications following radiofrequency ablation (RFA) for painful spinal osteoid osteoma (OO).
METHODS
PubMed, Scopus, and CENTRAL databases were searched in accordance with PRISMA guidelines. Studies with available data on safety and clinical outcomes following RFA for spinal OO were included.
RESULTS
In the 14 included studies (11 retrospective; 3 prospective), 354 patients underwent RFA for spinal OO. The mean ages ranged from 16.4 to 28 years (Females = 31.3%). Lesion diameters ranged between 3 and 20 mm and were frequently seen in the posterior elements in 211/331 (64%) patients. The mean distance between OO lesions and neural elements ranged between 1.7 and 7.4 mm. The estimated pain reduction on the numerical rating scale was 6.85/10 (95% confidence intervals [95%CI] 4.67-9.04) at a 12-24-month follow-up; and 7.29/10 (95% CI 6.67-7.91) at a >24-month follow-up (range 24-55 months). Protective measures (e.g., epidural air insufflation or neuroprotective sterile water infusion) were used in 43/354 (12.1%) patients. Local tumor progression was seen in 23/354 (6.5%) patients who were then successfully re-treated with RFA or open surgical resection. Grade I-II complications such as temporary limb paresthesia and wound dehiscence were reported in 4/354 (1.1%) patients. No Grade III-V complications were reported.
CONCLUSION
RFA demonstrated safety and clinical efficacy in most patients harboring painful spinal OO lesions. However, further prospective studies evaluating these outcomes are warranted.
Topics: Adolescent; Adult; Bone Neoplasms; Catheter Ablation; Female; Humans; Osteoma, Osteoid; Prospective Studies; Radiofrequency Ablation; Retrospective Studies; Spinal Neoplasms; Treatment Outcome; Young Adult
PubMed: 35358911
DOI: 10.1016/j.suronc.2022.101747 -
European Journal of Medical Research Jan 2019OO (osteoid osteoma) is a common, osteoblastic, benign bone tumor but rarely seen in the hand region. There is still some debate about the diagnosis and treatment of...
BACKGROUND
OO (osteoid osteoma) is a common, osteoblastic, benign bone tumor but rarely seen in the hand region. There is still some debate about the diagnosis and treatment of hand OOs. In the present study, we aimed to evaluate the epidemiology, radiologic features, surgical treatment options and functional outcomes.
METHODS
Between January 2003 and December 2014, surgically treated and pathologically verified 9 hand OO cases were investigated retrospectively. The preoperative and postoperative clinical outcome scores were calculated using the M2-DASH (Manchester-Modified Disabilities of Arm Shoulder and Hand) Score.
RESULTS
Lesion locations were as follows: middle phalanx in 2/9 (22%) patients (2nd and 4th digit), proximal phalanx in 6/9 (67%) patients (one 4th, two 2nd and three 5th digits) and metacarpal (2nd) in 1/9 (11%) patient. Incidence of nidus formation was 6/9 (67%) on X-ray, 7/9 (78%) on CT imaging and 2/9 (22%) on MR imaging. The mean time to diagnosis was 13.22 ± 5.44 months. Preoperative mean M2-DASH score was 41 ± 6 and postoperative was 7.4 ± 8.6.
CONCLUSION
Osteoid osteoma is usually seen below 25 years, and rarely found over 40 years of age. There is male dominance with a male to female ratio of 3:1. Delay of diagnosis may be encountered because of many differential diagnoses. When OO is suspected, CT imaging should be taken before the MR imaging. Because of superiority in soft tissue imaging, MR imaging should be an alternative tool in complex cases.
Topics: Adolescent; Adult; Bone Neoplasms; Female; Hand; Humans; Magnetic Resonance Imaging; Male; Osteoma, Osteoid; Retrospective Studies; Tomography, X-Ray Computed; Young Adult
PubMed: 30665467
DOI: 10.1186/s40001-019-0361-1 -
Foot and Ankle Surgery : Official... Feb 2021The literature published about osteoid osteoma (OO) in the ankle-foot consists mainly on case reports.
BACKGROUND
The literature published about osteoid osteoma (OO) in the ankle-foot consists mainly on case reports.
METHODS
We performed a retrospective study in which we analyzed demographic parameters, pain characteristics, treatment options and functional outcomes measured using the AOFAS and the SEFAS scales.
RESULTS
We treated 17 patients with OO around the ankle-foot. Eighty-eight percent of patients had night pain that was relieved with NSAIDs. The bones most often affected were the talus and calcaneus. OO was diagnosed 21 months after the onset of symptoms. Mean follow-up was 17.3 years. The surgical techniques most used were curettage and curettage and bone grafting. There was a significant increase in AOFAS and SEFAS scores after surgery.
CONCLUSIONS
Suspicion is the base of a prompt and a correct diagnosis of OO. The OO should be especially suspected in patients who present night pain that can be relieved with NSAIDs.
Topics: Adolescent; Adult; Ankle Joint; Bone Neoplasms; Bone Transplantation; Child; Curettage; Female; Fibula; Humans; Male; Middle Aged; Osteoma, Osteoid; Pain; Retrospective Studies; Tarsal Bones; Tibia; Young Adult
PubMed: 32370948
DOI: 10.1016/j.fas.2020.03.012 -
Seminars in Musculoskeletal Radiology Nov 2016Osteoid osteomas are small painful benign bone tumors that can be effectively treated by radiofrequency ablation (RFA) in most situations. This article briefly reviews... (Review)
Review
Osteoid osteomas are small painful benign bone tumors that can be effectively treated by radiofrequency ablation (RFA) in most situations. This article briefly reviews the typical imaging findings of osteoid osteomas and the RFA technique used to treat them at our institution. It concludes with several examples of osteoid osteomas in difficult-to-reach places and the approaches used to access and treat them.
Topics: Bone Neoplasms; Catheter Ablation; Diagnostic Imaging; Humans; Osteoma, Osteoid; Radio Waves
PubMed: 28002870
DOI: 10.1055/s-0036-1594280 -
In Vivo (Athens, Greece) 2021Osteoid osteoma, the third most common benign bone tumor, usually occurs in the cortex of long bones. It consists of a radiolucent nidus surrounded by reactive... (Review)
Review
Osteoid osteoma, the third most common benign bone tumor, usually occurs in the cortex of long bones. It consists of a radiolucent nidus surrounded by reactive osteosclerosis. Generally, osteoid osteoma affects young males. Nocturnal pain that eases with salicylates or nonsteroidal anti-inflammatory drugs (NSAID) is the typical clinical presentation. Sometimes, it remains undiagnosed for a long time. Plain radiography and computed tomography are usually sufficient for the diagnosis of osteoid osteoma. Initial treatment includes salicylates and NSAID because the tumor often regresses spontaneously over 2-6 years. Surgical treatment is indicated in case of unresponsive pain to medical therapy, no tolerance of prolonged NSAID therapy due to side effects, and no willingness to activity limitations. Nowadays, minimally invasive techniques have replaced open surgery and are considered the gold standard of surgical treatment. Although cryoablation seems superior in terms of the nerve damage and immunotherapy effect, radiofrequency ablation is the preferred technique.
Topics: Bone Neoplasms; Bone and Bones; Humans; Male; Osteoma, Osteoid; Radiography; Tomography, X-Ray Computed
PubMed: 34182465
DOI: 10.21873/invivo.12459