Osteoid Osteoma (Nonsurgical Management In Children)
An osteoid osteoma is a noncancerous bony tumor that most commonly develops in the body's long bones, such as the femur (thighbone) and tibia (shinbone). Although osteoid osteomas are painful, they do not spread throughout the body. Osteoid osteomas can occur in people of all ages, but they are more common in children and young adults.
Osteoid osteomas are usually less than 1.5 cm in size and do not grow. However, they usually result in a large amount of reactive bone forming around them. They also produce osteoid bone, a new type of abnormal bone material. This osteoid bone, along with tumor cells, forms the nidus of the tumor, which is visible on X-rays. Osteoid osteomas can occur in any bone in the body, but they are most commonly found in the legs. They are also found in the fingers, hands and spine.
Osteoid osteomas can occur at any age, but they are most common between the ages of 4 and 25. Males are affected approximately three times more frequently than females. Osteoid osteomas are not cancerous (noncancerous) and do not spread to other parts of the body (metastasize). The exact cause of osteoid osteomas is unknown.
Symptoms:
The pain from an osteoid osteoma is dull and aching, but it can worsen and become severe, especially at night. The pain is usually unrelated to the activity. Sometimes a person may suffer from the uncomfortable, bothersome pain of an osteoid osteoma for years before seeking medical attention.
Imaging Studies:
X-rays
X-rays: X-rays provide a clear picture of dense structures such as bone and can help in the diagnosis of an osteoid osteoma. An x-ray of the area may reveal thickened bone surrounding a small central core of lower density, which is a characteristic of the tumor.
Computed tomography scan:
Computed tomography scan: A CT scan provides a cross-sectional image of the bone and can be used to assess the lesion. A CT scan will frequently reveal the nidus—or tumor center.
Biopsy
Biopsy: A biopsy may be required to confirm the diagnosis of osteoid osteoma. A biopsy involves the removal of a tissue sample from the tumor and examined under a microscope.
Treatment:
Medical management:
Most of the osteoid osteomas will disappear on their own after a few years. Nonsteroidal anti-inflammatory drugs such as ibuprofen, aspirin and naproxen may provide pain relief for some people.
Surgical Treatment:
Many patients have painful symptoms that NSAIDs do not alleviate, or they do not want to wait years for the tumor to shrink. They may consider surgery in these circumstances. It carries risks, including general anesthesia, infection, bleeding, and possible tissue damage.
Radiofrequency Ablation:
A newer effective treatment option performed in a daycare setting removes the tumor's core using minimally invasive techniques such as CT-guided radiofrequency ablation performed under general anesthesia. The tumor is heated with a high-frequency electrical current and destroyed during this outpatient procedure.
The tumor is then probed with a radiofrequency probe. The probe heats the tumor tissues and kills them. The surrounding tissues are only slightly damaged. In most patients, one radiofrequency probe treatment is sufficient to remove the tumor. The procedure lasts about 2 hours and is followed by a 2-hour recovery period, after which you can go home with a mild pain reliever.
Recovery:
The time it takes to resume normal activities depends on the procedure and the location of the tumor. Sometimes patients can return to work or school with some restrictions after a few days.
