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. 2018 Sep 25;10(3):7496.
doi: 10.4081/or.2018.7496. eCollection 2018 Sep 5.

Osteoid osteoma: Contemporary management

Shahryar Noordin  1 , Salim Allana  2 , Kiran Hilal  3 , Naila Nadeem  3 , Riaz Lakdawala  1 , Anum Sadruddin  4 , Nasir Uddin  5
Affiliations

Osteoid osteoma: Contemporary management

Shahryar Noordin et al. Orthop Rev (Pavia). .

Abstract

Osteoid osteoma is a benign bone-forming tumor with hallmark of tumor cells directly forming mature bone. Osteoid osteoma accounts for around 5% of all bone tumors and 11% of benign bone tumors with a male predilection. It occurs predominantly in long bones of the appendicular skeleton. According to Musculoskeletal Tumor Society staging system for benign tumors, osteoid osteoma is a stage-2 lesion. It is classified based on location as cortical, cancellous, or subperiosteal. Nocturnal pain is the most common symptom that usually responds to salicyclates and non-steroidal anti-inflammatory medications. CT is the modality of choice not only for diagnosis but also for specifying location of the lesion, i.e. cortical vs sub periosteal or medullary. Non-operative treatment can be considered as an option since the natural history of osteoid osteoma is that of spontaneous healing. Surgical treatment is an option for patients with severe pain and those not responding to NSAIDs. Available surgical procedures include radiofrequency (RF) ablation, CT-guided percutaneous excision and en bloc resection.

Keywords: Osteoid osteoma; benign; imaging; management; pathogenesis; tumor.

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Conflict of interest statement

Conflict of interest: the authors declare no conflicts of interests.

Figures

Figure 1.
Figure 1.
Pictorial representation of osteoid osteoma.
Figure 2.
Figure 2.
Histology of osteoid osteoma. The nidus is composed of densely broad sclerotic bone trabecuale show osteoblastic rimming and fibrovascular connective tissue.
Figure 3.
Figure 3.
The bony trabeculae can be thin as seen in this image.
Figure 4.
Figure 4.
A 10 years old boy with humeral osteoid osteoma. A) AP radiograph shows radiolucent nidus arrow and surrounding sclerosis. B) Coronal STIR image shows hypointense lesion long arrow (nidus) and perilesional edema (small arrow). C) Axial T1-weighted and corresponding post contrast T1-weighted Fat sat images show hypointense nidus on pre contrast image with intense enhancement on pot contrast images (long arrow). D) Technetium-99 bone scan, AP projection shows focal region of radiotracer uptake, corresponding to tumor nidus (Arrow).
Figure 5.
Figure 5.
A 14 years old boy osteoid osteoma of right femur. A) axial and B) coronal CT images show hypoattenuating nidus with surrounding sclerosis.
See this image and copyright information in PMC

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