J Korean Soc Radiol.  2015 Apr;72(4):255-262. 10.3348/jksr.2015.72.4.255.

Efficacy of Computed Tomography Guided Radiofrequency Ablation for Osteoid Osteomas in 31 Patients

• Kim J
• Ahn JM
• Lee JW
• Lee GY
• Lee E
• Oh JH
• Cho HS
• Kang HS

• KMID: 1941756
• DOI: http://doi.org/10.3348/jksr.2015.72.4.255

Abstract

PURPOSE
To present the clinical outcome of computed tomography (CT) guided radiofrequency ablation (RFA) for osteoid osteoma.
MATERIALS AND METHODS
Thirty-one patients (M:F = 23:8, mean age: 20 years, range: 4-54 years) who underwent RFA for clinically suspected osteoid osteoma from May 2004 to December 2013 were retrospectively reviewed. RFA was done in all cases under CT guidance by one of three radiologists in our department. Electronic medical records and images were retrospectively reviewed in all patients.
RESULTS
Lesions were located in femur (n = 20), tibia (n = 5), fibula (n = 2), humerus (n = 3), talus (n = 2), and calcaneus (n = 1). On discharge, 27 of 33 cases showed complete remission of pain (82%). One major complication (compartment syndrome) and 2 minor complications (reactive synovitis, minimal skin burn at electrode insertion site) were observed. On the last follow-up (0-78 months, mean: 12.6 months) 27 of 33 cases were successfully treated (82%) and had no more complaints. 3 cases presented remaining pain (9%). In 3 cases relapse occurred (9%) and RFA was repeated in 1 case. The repeated treatment was successful.
CONCLUSION
CT-guided RFA is an effective method for the treatment of osteoid osteoma.

MeSH Terms

Burns
Calcaneus
Catheter Ablation*
Electrodes
Electronic Health Records
Femur
Fibula
Follow-Up Studies
Humans
Humerus
Osteoma, Osteoid*
Recurrence
Retrospective Studies
Skin
Synovitis
Talus
Tibia

Figure

• 

  Fig. 1 A 14-year-old female patient who was diagnosed as osteoid osteoma. A. Non-contrast hip-CT shows typical nidus with internal calcification at right distal femur with adjacent prominent cortical thickening (black arrow). B. MRI shows intermediate signal intensity (SI) in the nidus on T1-weighted image and high SI on T2-weighted image with internal dark SI of calcification on all sequences (white arrows). C. The lesion was successfully treated by computed tomography guided radiofrequency ablation.

• 

  Fig. 2 A 40-year-old male patient who was diagnosed as osteoid osteoma. A. Axial and coronal hip-CT scan shows a small osteolytic lesion with surrounding cortical thickening and sclerosis at left proximal femur, lesser trochanteric area (white arrows). The lesion is suspected as intra-articular location. B. To avoid possible heat damage to the surrounding tissue around the hip joint, needle tip is located at deep aspect to the nidus.

• 

  Fig. 3 Radiofrequency ablation device.

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