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Purpose: Osteoid osteomas are benign and nonprogressive lesions. The clinical presentation of osteoid osteoma is typical with night pain responsive to nonsteroidal anti-inflammatory agents. The typical radiological appearance is lucent nidus and adjacent reactive sclerosis. The most traditional management of osteoid osteoma is surgical removal which is associated with significant morbidity. This article aims to demonstrate our single-center experience of 55 patients with osteoid osteoma treated with percutaneous radiofrequency ablation (RFA)., Methods: Fifty-five symptomatic patients who were seen at our orthopedics outpatient clinics, diagnosed with osteoid osteoma, and referred to interventional radiology department between May 2015 and April 2019 were enrolled. The nidus size, pain numeric rating scale score, and intramedullary edema diameter before and after RFA were compared. Clinical and technical success, intervention-related complications, and need for subsequent ablation were recorded., Results: Of the 55 patients, including 12 pediatric cases, 6 had atypical locations such as metatarsal, vertebra, and scapula, while 1 case had osteoid osteoma with multiple nidus. The mean age was 18.5 ± 9.6 years. Preintervention maximum nidus diameter, pain score, and edema diameter were significantly lower in postintervention measurements ( p < 0.001). Technical success rate was 98.1%, and clinical success was 96.36%. Severe complication occurred in one patient with soft tissue burn and osteomyelitis., Conclusion: This is one of the largest series of osteoid osteoma treated with RFA done in a single center with atypical cases. In conclusion, RFA is safe and effective in both pediatric and adult patients with rare complications even in challenging cases with atypical locations.

Surgical excision is the traditional treatment for osteoid osteoma. However, the complexity of the foot anatomy makes a satisfactory outcome challenging. Difficulty in localizing the lesion intraoperatively may result in either incomplete tumor resection or excessive bone loss. To date, no published report has described the use of three-dimensional printing in the surgical treatment of osteoid osteoma of the calcaneus. In this case, we printed a three-dimensional model of the calcaneus of a 17-year-old female patient with a 2-year history of night pain in the lateral aspect of the hindfoot and ankle, evaluated the lesion as an osteoid osteoma, and designed a surgical guiding plate. Intraoperatively, we had no difficulty achieving complete resection of the lesion from the lateral calcaneus bone window, autogenous bone grafting, and subtalar arthrodesis. At the 2-year follow-up examination, the patient remained asymptomatic with no recurrence of the osteoid osteoma.

Osteoid osteomas are common benign tumors normally seen in the femur, tibia, and spine. They rarely are seen in the foot. We present an unusual case of osteoid osteoma of the cuboid in a 26-year-old man. This was initially thought to be an ankle sprain, as its first presentation was after a sporting injury. It was then treated as an infection before the true diagnosis--that of osteoid osteoma--was obtained.

Osteoid osteomas are benign osseous lesions. They have seldom been described in the otolaryngology literature, and they are extremely rare in the ethmoid sinuses. We report a new case of osteoid osteoma of the ethmoid sinus in a 15-year-old girl. The workup consisted of computed tomography. Treatment involved local excision via an external ethmoidectomy approach. The diagnosis was based on histopathologic examination.

Diagnosing osteoid osteomas in the small bones of the hands and feet is difficult because of their atypical presentations. We report an 8-year-old boy who presented with pain in the left ankle and a limp. Plain radiographs of the ankle and foot were normal; the diagnosis was eventually made using magnetic resonance imaging.

Osteoid osteomas may be treated medically or surgically; both have similar long-term outcomes. Nonetheless, only surgery allows complete excision of the lesion for histological analysis. Excessive removal of surrounding bone may destabilise and weaken the bony structure and predispose it to fractures. We describe a surgical technique using a bone graft trephine to enable precise lesion removal with minimal bone excision.

Diagnosis and treatment of intra-articular osteoid osteoma is challenging. We present 16 patients with intra-articular osteoid osteomas of the hip treated with percutaneous radiofrequency ablation. Eight osteoid osteomas were located in the femoral head, six in the femoral neck, and two in the acetabulum. Three of the 16 patients had had an incorrect previous diagnosis. Percutaneous radiofrequency ablation was a clinical and technical success in all 16 patients. Within the first 24 h after the procedure, pain improved in all patients. Five patients had pain relief within the first 3 days after the procedure, nine patients within the first week and two patients within 2 weeks. Residual or recurrent symptoms were not reported by the last follow-up. At the 12-month follow-up, computed tomography and magnetic resonance imaging showed complete ossification and bone regeneration at the site of the lesion in three patients, partial ossification in six patients and no changes in seven patients. Computed tomography-guided percutaneous radiofrequency ablation is a simple, minimally invasive, safe and effective method for the treatment of most intra-articular osteoid osteomas.

We report five cases of intra-articular osteoid osteoma. Physical findings of osteoid osteoma vary with the site of the tumor. Juxta- and intra-articular osteoid osteomas present various atypical and nonspecific features. They are recorded both for their rarity and for the unusual clinical and roentgenographic findings that may delay diagnosis or induce misdiagnosis. Specialized imaging techniques may hasten diagnosis, but only an accurate clinical history, with a high index of suspicion, can allow for a proper diagnosis. When the diagnosis is suspected, we suggest that the most sensitive test is a "three-phase" technetium-99m bone-scan followed by computerized tomographic-scanning. Detailed evaluation of the suspected area, using thin sections is required to prevent misinterpretation, especially in a diagnosis involving first sprain of an ankle. The following cases of intra-articular osteoid osteoma illustrate the problems encountered in their diagnosis.

Pathologic conditions of the lateral talar process may be difficult to diagnose using physical examination and roentgenographs. A computed tomography scan of the hindfoot is often useful to define lesions of the lateral process. We report a case of osteoid osteoma of the lateral talar process that defied diagnosis for 4 years. The patient had an antecedent history of an inversion injury, which had been treated as a chronically painful sprained ankle without resolution of symptoms. The tumor was ultimately identified on a computed tomography scan, best seen on a coronal section through the talus. The patient had complete relief of pain after excisional biopsy of the tumor.

This article describes two cases of juxta-articular osteoid osteoma of talar neck. Both patients were initially treated as having ankle sprains or arthritis before diagnosis of osteoid osteoma. A high index of suspicion and appropriate imaging studies are important to make an early diagnosis of this disorder. Once diagnosis is confirmed, en bloc resection and autogenous bone graft can cure the disorder.

Five patients with osteoid osteomas of the talar neck were treated at the Hospital for Special Surgery between 1981 and 1992. The course of care leading to definitive diagnosis and treatment was reviewed. All five of the patients had night pain relieved by aspirin or nonsteroidal anti-inflammatory drugs. One of the five reported associated trauma. The average time from onset of symptoms to correct diagnosis was 2.5 years. Juxta-articular osteoid osteoma can cause a small spur that resembles a traction spur on the neck of the talus. Anterior ankle impingement was the most common misdiagnosis. Initial treatments included arthroscopic spur debridement or synovectomy, casting for fracture, and repeated nerve blocks for reflex sympathetic dystrophy. The five patients were cured by en bloc excision of the lesion. In the diagnosis of osteoid osteoma, a history of relief of pain with aspirin is important. Plain radiographs and a bone scan are useful. Fine cut computed tomography scanning or magnetic resonance imaging are the best studies for making a definitive diagnosis. Localization by computed tomography guided needle placement or intraoperative radionuclide scanning are recommended to find the lesion for excision. Intraoperative radiographs of the excised lesion should be used to confirm complete removal.

Preoperative localization of osteoid osteoma using a bone biopsy needle and methylene blue tissue staining is quick, inexpensive, accurate and easy to perform. This technique allows the surgeon to limit resection to the nidus of the lesion and minimal surrounding bone. No hardware is left in situ, so the surgical exposure and dissection planes are not limited by localization hardware.

An unusual case of osteoid osteoma is reported emphasizing the necessity of a careful history and physical examination combined with an adequate imaging supply. Treatment was surgical with an en bloc excision of the lesion.

The purpose of this paper is to present a progressive diagnostic and management program for osteoid osteoma of the femoral neck in the young athlete. Five young athletes with hip pain secondary to osteoid osteoma are presented. The average age of the patients was 15 years old, with an average followup of 4 years. Radioisotope bone scans, computed axial tomograms, and linear tomograms were valuable diagnostic aids. All five athletes were treated with a limited excisional biopsy via an anterior approach to the femoral neck. Associated treatment modalities, such as bone grafting, internal fixation, and cast immobilization, were not necessary. There were no major complications. The five young athletes returned to sports at an average of 4 months postoperatively. Osteoid osteoma of the femoral neck should be included in the differential diagnosis of hip pain in young athletes. A limited excisional biopsy provided a rapid return to sports for the young athlete without the potential morbidity associated with internal fixation, bone grafting, and cast immobilization.