Such benign and painful bone lesions, as osteoid osteomas, fibroangiomas and chondromas, develop in anatomically complex regions; therefore, to treat them surgically would be too invasive as compared to their stage; in addition, these lesions are often found in very young patients. As a consequence, in concert with the orthopedic surgeons of our hospital, we decided to treat some young patients, affected by benign and painful bone lesions, with Magnetic Resonance guided Focused Ultrasound Surgery (MRgFUS), in order to evaluate the safety and efficacy of...

From November 2011, we selected 9 surgically untreatable bone lesions including four osteoid osteomas located: in the femoral epiphysis (n.1), in the tibial diaphysis (n. 2), and in the talus (n. 1); two chondroblastomas of the knee tibial plateau (n. 2) with a mean diameter of 30 mm; two fibroangiomas of the humeral head (n. 1) and foot (n. 1); one periosteal chondroma of the femoral neck (n.1). Patient age ranged between 13 and 30 years (mean age, 21 years). All the lesions were studied...

Clinical results: After treatment with MRgFUS, all but one patients showed regression in painful symptomatology with a mean VAS decreasing from 7.9 to 2.3. In the patient with periosteal chondroma of the femoral neck no improvement in symptomatology was observed. Imaging results: all patients were assessed by CT and MRI before and after treatment; in particular, MRI was performed without gadolinium in the four cases of osteoid osteomas (OO) and without and with gadolinium. In the four cases of OO, the most important findings were...

This study describes a new way of treating benign and painful bone lesions. The clinical results depend on patient selection: MRgFUS, in fact, has an important limit, being a technique that destroys target tissue through heat generated by a high intensity focused ultrasound beam. The penetration of the US beam in the body, and in the lesion, depends on the type of tissue traversed: in absence of reflection or refraction of the US beam, the whole energy reaches the target lesion, but if the US...

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