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Osteoid osteoma treatment
Osteoid osteoma is a benign bone tumor that occurs in the cortex (hard portion) of bone. It can frequently cause severe pain and can occur in a variety of bones throughout the body. It classically causes night pain that is relieved by anti-inflammatory medications such as ibuprofen or aspirin. It can lead to changes in the affected bone with increased bone formation around a small central hole in the bone called a "nidus".
Osteoid osteoma treatment
Radiofrequency Ablation (RFA)
A special needle is inserted into the "nidus" of the osteoid osteoma that allows the Interventional Radiologist to heat up the osteoid osteoma, killing the cells responsible for pain and growth of the osteoid osteoma. This has been shown to be greater than 90% effective in curing the condition and symptoms.
The procedure typically requires 30 - 60 minutes to complete.
Typically, sedation or anesthesia will be used to help facilitate the successful completion of the procedure. This helps to minimize anxiety for the child and decrease risk of complications as a result of movement during the procedure.
The child will be positioned on the imaging table. Real-time X-rays (fluoroscopy) or CT imaging can be used to exactly localize the osteoid osteoma and help precisely position the needle for the RFA procedure. The skin surface will be cleaned to allow for a sterile skin puncture site. Local anesthetic will be introduced to help with comfort at the expected skin puncture site prior to a small skin nick being made to permit insertion of the needle into the osteoid osteoma.
The RFA needle is then removed and a bandaged placed to cover the puncture site.Typically patients go home the same day of the procedure with pain medicine if needed.
Your child will typically have some soreness at the puncture site due to the placement of the needle that is different than the original pain from the osteoid osteoma. The pain from the osteoid osteoma can be immediately relieved or take several days to resolve following the RFA procedure. Typically this can be well controlled with ibuprofen or acetaminophen (Tylenol®) or stronger medications.
Your child can resume bathing the same day. Your child can resume activities as tolerated following recovery from sedation and/or anesthesia.
Benefits and risk of treatment
- Avoid open surgical resection.
- Alleviate pain associated with the osteoid osteoma and/or eliminate the need for medication to control pain
- Any procedure where the skin is penetrated carries a potential risk of infection. The chance of developing an infection that requires added antibiotic treatment appears to be less than one in 1,000.
- Rarely significant bleeding may occur
- Potential injury of nearby tissue or the skin surface from heating the osteoid osteoma with the RFA needle
Children's Wisconsin's imaging department was re-designated as a Diagnostic Imaging Center of Excellence by the American College of Radiology. Our imaging department was the third children's hospital in the nation to receive this prestigious credential.