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Osteoid Osteoma; A Diagnostic Protocol and Treatment with Computed Tomography Guided Radio Frequency Ablation in a Series of 36 Patients.

Volume 7 | Issue 3 | September-December 2021 | Page: 13-16 | Sandeep Patwardhan, Arkesh Madegowda, Ashok Shyam, Parag Sancheti


Authors: Sandeep Patwardhan MS Ortho. [1], Arkesh Madegowda MS Ortho. [1], Ashok Shyam MS Ortho. [1, 2], Parag Sancheti MS Ortho. [1]

[1] Department of Paediatric Orthopaedics, Sancheti Institute for Orthopaedics and Rehabilitation, Pune, Maharashtra, India.
[2] Department of Research, Indian Orthopaedic Research Group, Thane (W), Maharashtra, India.

Address of Correspondence
Dr Arkesh Madegowda
Department of Paediatric Orthopaedics, Sancheti Institute for Orthopaedics and Rehabilitation, Pune, Maharashtra, India.
E-mail: dr.arkesh@gmail.com


Background and purpose: Osteoid osteoma (OO) constitutes 10-12% of all benign bone tumours making it one of the most commonly occurring bone tumour. Radiofrequency ablation (RFA) offers a minimally invasive day care treatment option where in the tumour cells in the nidus are thermo-coagulated. The purpose of this study is to highlight the diagnostic protocol of OO and evaluate the safety and efficacy of RFA in its treatment.
Methods: A total of 36 patients (26 male, 10 female patients; mean age 10.33 years; age range 4-20 years) who underwent Computerized tomography (CT) guided RFA treatment for osteoid osteoma of various anatomical locations were included in this study. Patients underwent radiography and CT evaluation for diagnosis. When classical symptoms were absent and CT was inconclusive, patients underwent further evaluation with magnetic resonance imaging (MR) and nuclear scan. Features suggestive of OO in any two of these investigations was considered confirmatory and such patients were offered RFA. Patients were assessed for abolition of pain after treatment and complications if any were recorded.
Results: The intra nidus location of probe which was considered as technical success was noted in all patients. There was significant improvement in pain after RFA. Visual Analogue Scale (VAS) score improved from 7.2 preoperatively to 0.6 and 0.0 at 3 months and 6 months respectively. Two patients of tibia OO had superficial skin burns that healed within 2 weeks. One patient sustained tibia fracture at RFA site after a fall and but was pain free after 20 weeks. At the latest follow up of 28 months (range 14-56 months), there were no recurrences.
Conclusion: Diagnosis of osteoid osteoma may be challenging at times and additional investigations like MRI/nuclear bone scan along with radiography and CT aid in making an appropriate diagnosis. CT guided radiofrequency ablation of osteoid osteoma is a safe, effective and minimally invasive treatment modality with low complication rates.
Keywords: Osteoid osteoma, Computed tomography guided, Radiofrequency ablation, Minimally invasive, Day care.


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How to Cite this Article:  Patwardhan S, Madegowda A, Shyam A, Sancheti P | Osteoid Osteoma; A Diagnostic Protocol and Treatment with Computed Tomography- Guided Radio Frequency Ablation in a Series of 36 Patients | International Journal of Paediatric Orthopaedics | September- December 2021; 7(3): 13-16.

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