Learning objectives
To demonstrate the efficiency of computed tomography (CT) guided radiofrequency ablation (RFA) as a minimally invasive procedure in osteoid osteoma treatment,
presenting the different steps of this technique.
Background
Introduction
Osteoid osteoma is a small and benign painful osteoblastic lesion with specific imaging findings and symptoms.
It represents 10% of all skeletal lesions(1).
The lesion is characterized by two zones (Fig.
1):
-Central zone:composed of atypical bone known as thenidus;
-Peripheral zone:sclerotic bonethat contains osteoclasts,
osteoblasts and dilated capillaries.
It usually affects children and young adults between the ages of 10 to 35 years-old,
with a male predominance.
Osteoid osteoma has a higher incidence in long bones (Fig.
2),
mostly affecting the diaphysis of...
Imaging findings OR Procedure Details
Several clinical cases from our Department were selected in order to illustrate the typical aspect of osteoid osteoma and its treatment with RFA guided by CT.
Relative contraindications to RFA include a lesion located in the hand or in the spine (<1cm from vital structures such as nerves),
pregnancy,
cellulitis,
sepsis and coagulopathy.
Lesions that have a nidus bigger than 1 cm generally need multiple applications of the electrode in several positions(6).
The procedure has several steps and is performed under aseptic conditions with general...
Conclusion
CT-guided RFA is a minimally invasive,
safe and effective treatment for osteoid osteoma lesions.
Comparing to traditional surgical resection,
it has less complications and reduced mortality.
With a focus on that,
RFA should be the conventional therapeutic method used for osteoid osteoma.
References
1.Helms CA,
Hattner RS,
Vogler JB.
Osteoid osteoma: radionuclide diagnosis.
Radiology.
2014;
2.Rosenthal DI,
Marota JJA,
Hornicek FJ.
Osteoid Osteoma: Elevation of Cardiac and Respiratory Rates at Biopsy Needle Entry into Tumor in 10 Patients.
Radiology.
2007;
3.Kransdorf MJ,
Stull MA,
Gilkey FW,
Moser RP.
From the Archives of the AFIP - Osteoid osteoma.
RadioGraphics.
1991;
4.Liu PT,
Chivers FS,
Roberts CC,
Schultz CJ,
Beauchamp CP.
Imaging of Osteoid Osteoma with Dynamic Gadolinium-enhanced MR Imaging.Radiology.
2007;
5.Rimondi E,
Mavrogenis AF,
Rossi G,
Ciminari R,
Malaguti...