The term nidus, which was described as the core or niduslike focus by jaffe in 1953, refers to the tumor itself and is composed of bone. Osteoid osteoma is a benign tumor of the bone affecting children and young adults. Initial treatment of osteoid osteoma is nonoperative. Dec 10, 2014 seven patients affected by osteoid osteoma were consecutively recruited for mrgfus exablate 2100, insightec, israel on 1. Twelve preoperative magnetic resonance imaging scans of confirmed cases of osteoid osteoma were collected. The diagnostic accuracy of mri versus ct imaging for. Osteoid osteoma is a benign boneforming neoplasm, first described by jaffe in 1935. Aug 27, 2008 osteoid osteoma is a benign tumor of the growing skeleton. We have excised oos of the cervical spine with the use of fdg positron emission tomograph. Osteoid osteoma is a benign neoplasm with a nidus of osteoidrich tissue that typically causes an. Generally, compared to mri, ct scan is more specific for spotting a nidus.
We herein analyse a case of misdiagnosis of oo of the talus and discuss how to improve the early diagnosis of this rare. The role of ct and mri in evaluation of osteoid oteoma elene iordanishvili tbilisi sate medical university. Signals in mr imaging differ among bone marrow edema, nidus and. Aug 08, 2019 initial treatment of osteoid osteoma is nonoperative. The condition was first described in 1930 by bergstrand, and jaffe first characterized osteoid osteoma as a discrete clinical entity in 1935. An osteoid osteoma on mri may mimic findings of a malignant tumor such as ewingas sarcoma or osteomyelitis because of the presence of marrow and soft tissue edema that can be extensive and make it difficult to discern a nidus. Osteoid osteoma is the most commonly seen benign boneforming lesion, accounting for 10% to 12% of all benign bone tumors and 3% of all primary bone tumors. Osteoid osteoma does not grow or behave in a locally aggressive manner, and it has no potential for malignant transformation. Only a clinical history of skeletal pain was given. Mar 11, 2005 we present a case of osteoid osteoma found in an unusual location.
Symptoms and history pain is the common symptom of osteoid osteoma. The role of magnetic resonance imaging mri in the diagnosis of osteoid osteoma is still controversial. Mri should be performed with gadolinium if possible. Mrgfus of osteoid osteoma started at the rizzoli journal of. As mrgfus is a noninvasive and radiationfree treatment, it stands to replace the current standard of care, percutaneous radiofrequency, or laser thermal ablation.
Mri web clinic march 20 intraarticular osteoid osteoma mri of bone and soft. Osteoid osteoma from the laboratory of anatomy and orthopaedic. The osteoid osteoma was removed by curettage, which gave the patient a complete relief of his presenting symptoms. They have a characteristic lucent nidus osteoid osteoma was first described by jaffe in 1935 and accounts for 10% of all benign bone tumors. Osteoid osteoma of the fifth metatarsal bone his right.
Contrastenhanced mri predicts local recurrence of osteoid. Osteoid osteoma is classically characterized at con. Establishing a clinical service for the treatment of. Osteoid osteomathe role of bone scans in diagnosis and. This case demonstrates the rare anatomic position of osteoid osteoma. Osteoid osteoma was first described by jaffe in 1935 and accounts for 10% of all benign bone tumors. Osteoid osteoma is a benign bone tumor that is commonly located in the proximal femur. A 17 year old boy presented with history of pain in the lower end of femur and knee since past 2 months, aggravated in the past few weeks. Lesions were classified as benignlatent, benignaggressive, or malignant. In the paediatric age group, since the history may be difficult to elicit, there are often problems in early diagnosis. Approximately 10% of all benign bone tumors are osteoid osteomas 2, 3. Osteoid osteoma is the third most common benign neoplasm of bone, occurring predominantly in young, male patients. Minimally invasive treatment options have become the standard of care for osteoid osteoma and at present radiofrequency ablation is the treatment of choice.
Many patients over the age of 10 can enroll in a clinical trial to treat osteoid osteomas with highfrequency focused ultrasound hifu. Osteoid osteoma is characterized by anastomosing woven bone trabeculae, rimmed by a single layer of prominent osteoblast. Pdf osteoid osteoma is a benign boneforming tumor with hallmark of tumor cells directly. Background osteoid osteoma is a benign osteoblastic tumor that bergstrand first described in 1930. Osteoid osteoma is composed of a nidus of woven bone and osteoid rimmed with osteoblasts, with a surrounding reactive zone of thickened cortical or trabecular bone and loose fibrovascular tissue fig 1. In fact, mri has been reported to be a misleading technique, because extensive edema and soft tissue reaction can hide the nidus and cause a falsely aggressive appearance of this benign lesion 3, 11. Jaffe described it in 1935 and was the first to recognize it as a unique entity. Osteoid osteomas can be detected on an mri and ct scan, which are often used to identify the location of the nidus when the tumor is intraarticular. In the hand, osteoid osteoma is more commonly located in the phalanges and carpal bones. Osteoid osteomas can affect people of all ages but they occur more frequently in children and young adults. The characteristic finding on a ct scan is a target shaped nidus. The signal intensity of the nidus is variable on all sequences as is the degree of. Typical findings of osteoid osteoma are an intracortical nidus with fusiform cortical thickening, reactive sclerosis, and bone marrow edema.
Mri features after radiofrequency ablation of osteoid. Hip arthroscopy for the management of osteoid osteoma of. Only 5 cases of arthroscopic resections in the shoulder girdle have been described in the literature,, and only 1 article has discussed the use of this approach for treating juxtaarticular tumors involving the glenoid. Mri scan of 18 year old make with history of long standing pain in right. The lesion is most commonly located in the cortex of long bones where it is associated with dense, fusiform, reactive sclerosis. Except for its location, this case presented a classic history of osteoid osteoma producing night pain relieved by nonsteroid antiinflammatory drugs. Therefore, hip arthroscopy was used to treat this tumor.
This treatment option is low in both risk and morbidity and is therefore the best option in lesions that are difficult to access surgically because of the risks. Several imaging techniques have been used for the detection of osteoid osteoma lesions. Bone neoplasm chondrosarcoma ewing sarcoma metastatic cancer involving long bones osteoid osteoma osteosarcoma back links pages that link to this page knee effusion causes stress fracture tumors of the spine monoarticular arthritis low back pain in children causes of limp in children hip pain causes bone neoplasm. Imaging of osteoid osteoma with dynamic gadoliniumenhanced mr imaging. There are small sclerotic boneforming areas visible on technetium diphosphate bone scan. Xray and mri with marked sclerosis around the nidus. Case courtesy dr mohammad kazem tarzamni professor, department of radiology, tabriz university of medical science. Aug 08, 2019 background osteoid osteoma is a benign osteoblastic tumor that bergstrand first described in 1930. Osteoid osteomas hifu clinical trial ucsf radiology. An osteoid osteoma is a benign bone tumor that arises from osteoblasts and some components. The healing pattern of the nidus of osteoid osteomas has. The images below are from successful mrgfus treatments at stanford.
The first patient was treated in july 2014 and experienced a significant reduction in his pain, according to a press release from. Osteoid osteoma is a benign skeletal neoplasm composed of osteoid and woven bone that rarely exceeds 1. Jan 23, 2017 osteoid osteoma oo is a common benign bone tumour that is rarely found in the talus. Mrgfus of osteoid osteoma started at the rizzoli journal. Considering the rare intramedullary location of osteoid osteoma in our case, the dynamic gadoliniumenhanced mri has helped us to attain the diagnosis of osteoid osteoma over that of a more aggressive neoplasm or infection. A misdiagnosed case of osteoid osteoma of the talus. Osteoid osteoma from the laboratory of anatomy and orthopaedic department, university of ioannina, greece sushil. Osteoid osteoma is a boneproducing lesion frequently localized in long bones.
This tumor is most frequently found in the legs but may occur also at other bones in nearly any part of the body. Osteoid osteomas are benign boneforming tumors that typically occur in children particularly adolescents. Osteoid osteoma is a treatable benign bone tumor of unknown. To our knowledge, spinal osteoid osteoma with sciatica. Osteoid osteoma is a benign bone tumor that occurs most frequently in men and boys between 7 and 25 years old. In fact, mri has been reported to be a misleading technique, because extensive edema and soft tissue reaction can hide the nidus and cause a falsely aggressive appearance of this benign lesion. Nov 22, 2019 osteoid osteoma was first described by jaffe in 1935 and accounts for 10% of all benign bone tumors. Radiological examination typically shows radiolucent nidus within the affected bone. We present a case report highlighting the unusual location and atypical imaging characteristics of an osteoid osteoma in the juxtaarticular region of the femoral head, and treatment of the condition with radiofrequency ablation. Osteoid osteoma the role of bone scans in diagnosis and surgery margie matiets british columbia childrens hospital, lilncouver osteoid osteoma is a benign bone tumor which is most often seen in young males. Learn about diagnosing and treating this painful condition. The first patient was treated in july 2014 and experienced a significant reduction in his pain, according to a press release from sickkids. An osteoid osteoma is a benign bone tumor that arises from osteoblasts and some components of osteoclasts and was originally thought to be a smaller version of an osteoblastoma. This book is distributed under the terms of the creative commons.
Mr imaging is then used to confirm the success of the treatment at the end of the procedure. The healing pattern of osteoid osteomas on computed. Osteoid osteoma has the greatest incidence in the second and third decades of life 1025 years. The valuation of using fdg petct in detecting osteoid osteo. Lesions are classified according to the location of the nidus at radiologic imaging. An osteoid osteoma is a benign noncancerous bone tumor that usually develops in the long bones of the body such as the thighbone and shinbone. The results were compared with plain films, bone scintigraphy, computed tomography ct and pathological specimens. The author reports an unusual presentation of osteoid osteoma in a tenyearold girl, which could not be diagnosed by conventional xrays and ct scan. Osteoid osteoma is a benign osteoblastic neoplasm typically smaller than 1. The characteristic finding on a ct scan is a targetshaped nidus.
Osteoid osteomas are benign boneforming tumors that typically occur in. Osteoid osteomas can become painful enough to interfere with regular activity. The valuation of using fdg petct in detecting osteoid. Osteoid osteomas oos are bone tumors that rarely occur in the cervical spine. Mri web clinic march 20 intraarticular osteoid osteoma mri of bone and soft tissue tumors and tumorlike lesions. On contrastenhanced fatsuppressed t1weighted images the noncalcified nidi showed homogeneous enhancement, whereas the calcified lesions showed a ring. The atypical symptoms of oo and the presence of concurrent trauma or sports injuries may lead to misdiagnosis and delayed treatment. The left image shows an osteoid osteoma in the left lower leg, in the tibia, and the right image demonstrates an osteoid osteoma in the right foot, in the fifth metatarsal. Recent studies have demonstrated the effectiveness of magnetic resonanceguided focused ultrasound mrgfus in the treatment of osteoid osteoma oo, a painful, benign bone tumor. Osteoid osteoma dr francis deng and assoc prof frank gaillard et al. Osteoid osteoma of the sternum has not been published up to now.
Osteoid osteoma is the third most common benign neoplasm of bone, occurring predominantly in young, male patients 1. Surgical intervention is generally indicated for patients whose pain is unresponsive to medical therapy, those who cannot tolerate prolonged use of nonsteroidal antiinflammatory drugs nsaids, and those who are not amenable to activity restrictions. Pain classically is worse at night but can occur at any time of the day and be constant. We assessed the value of contrastenhanced fatsuppressed mri on nine patients with osteoid osteomas and osteoblastomas. The lesion can in most cases be detected on ct scan, bone scans and angiograms. Osteoid osteoma is a benign tumor of the growing skeleton. In most of cases, the patients report inflammatorylike pain that worsens at night and is alleviated with the use of nonsteroidal antiinflammatory drugs.
Most patients experience pain that worsens at night and is promptly relieved by the administration of salicylates. Osteoid osteoma may have an imaging appearance similar to those of other conditions, which can lead to confusion. Osteoid osteoma is a benign tumor that preferentially affects the long bones. A ct scan will reveal the nidus as a small area of low attenuation surrounded by reactive bone formation, seen as a larger area of higher attenuation. Magnetic resonance imaging scans are less useful, in that they will show extensive. The radiographic features consist of a central oval or round nidus surrounded first by a radiolucent area followed by another area of sclerotic bone. Although ct is helpful in the diagnosis of osteoid osteoma, patients in whom the clinical presentation of the tumor is atypical are first referred to undergo mri. Overview osteoid osteoma is a benign tumor of the bone. The goal of this study is to assess the value of contrastenhanced magnetic resonance imaging mri for predicting clinical success after rfa of osteoid osteoma.
The diagnosis of osteoid osteoma was based on typical clinical and imaging findings ct and mri. Intraarticular osteoid osteoma oo causes irreversible joint damage. Evidencebased information on osteoid osteoma from hundreds of trustworthy sources for health and social care. Bone scan or ct should be performed if an osteoma is suspected and not found on plain radiographs fig. We present a case of osteoid osteoma found in an unusual location. It is found most frequently in the second to third decade of life, and there is a pronounced male predominance 2.
Its pathologic hallmark is an osteoidrich nidus surrounded by vascular connective tissue. It is helpful to be aware of these conditions and their distinguishing imaging features. Plain radiographs and mri revealed features of osteoid osteoma of the right fifth metatarsal bone. Bone scan imaging can be helpful in identification of occult lesions, since osteoid osteomas are. Osteoid osteoma definition of osteoid osteoma by medical. A recent study assessed mrguided focused ultrasound to treat osteoid osteoma at the hospital for sick children sickkids in toronto, canada. It presents with pain, which is usually worse at night. Osteoid osteoma oo is a common benign bone tumour that is rarely found in the talus. Osteoid osteomas are benign painful skeletal neoplasms that preferentially afflict young male patients and are readily treatable. The tumor can be in any bone in the body but are most common in long bones, such as the femur and tibia. On contrastenhanced fatsuppressed t1weighted images the noncalcified nidi showed homogeneous enhancement, whereas the calcified.
Osteoid osteomathe role of bone scans in diagnosis and surgery. Hip arthroscopy for the management of osteoid osteoma of the. Osteoid osteoma is a benign neoplasm with a nidus of osteoidrich tissue that typically causes an intense. Mri features after radiofrequency ablation of osteoid osteoma.
They can be in any bone of the body but most commonly are seen in the long bones such as the femur and tibia. Osteoid osteoma is a benign osteoblastic tumor usually seen in adolescent and young males. The diagnostic accuracy of mri versus ct imaging for osteoid. The purposes of our study were to determine the temporal changes in mr signal in bone after radiofrequency ablation of osteoid osteoma and the size of the zone of marrow signal change pr. This bone tumor frequently affects the long bones of the femur and tibia. Osteoid osteoma treated with minimally invasive technique of radiofrequency ablation osteoid osteoma is a benign tumor of the bone. Its treatment of choice is radiofrequency ablation rfa.
Nov 01, 2009 osteoid osteoma has the greatest incidence in the second and third decades of life 1025 years. The most common presenting symptom is pain with nocturnal exacerbation, responsive to nonsteroidal antiinflammatory drugs. The current study is a retrospective analysis on 10 patients who were diagnosed with this rare spinal bone tumor. Jul 29, 2017 osteoid osteoma is a benign boneforming neoplasm, first described by jaffe in 1935. Oct 24, 2015 intraarticular osteoid osteoma oo causes irreversible joint damage. They have a characteristic lucent nidus less than 1. Osteoid osteoma is a painful benign tumour, which is commonly treated by radiofrequency ablation rfa. Osteoid osteoma is a tumor of children and young adults, it is very rare in older adults over the age of 50.
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