Fortschr Röntgenstr 2020; 192(04): 335-342
DOI: 10.1055/a-1012-2143
Technical Innovations
© Georg Thieme Verlag KG Stuttgart · New York

Atypically Located Osteoid Osteoma: Characteristics and Therapeutic Success After Image-Guided Thermal Ablation

Article in several languages: English | deutsch
Ricarda Johanna Seemann
1  Center for Muskuloskeletal Surgery, Charité – University Medicine Berlin, Germany
,
Sven Märdian
1  Center for Muskuloskeletal Surgery, Charité – University Medicine Berlin, Germany
,
Philipp Schwabe
2  Department for Trauma and Orthopaedic Surgery, Vivantes-Hospital Spandau, Berlin, Germany
,
Florian Streitparth
3  Department of Radiology, Ludwig-Maximilians-University Munich, München, Germany
› Author Affiliations
Further Information

Publication History

22 May 2019

01 September 2019

Publication Date:
20 November 2019 (online)

Abstract

Purpose While ostoeid osteomas (OO) are typically located in long tubular bones, OO occurring elsewhere are referred to as “atypical”. Aim of our study was to review the characteristics of atypically located OO, course of symptoms and therapy, as well as clinical outcome, safety, and patient satisfaction of radiofrequency ablation (RFA).

Materials and methods In the period from 04/01 to 07/13, 33 patients were treated using thermal ablation (RFA or laser), partly with low temperature and short duration technique. Clinical records were analyzed. Additionally, 23 patients were interviewed via telephone. Primary endpoints were technical success, clinical success (recurrence rates), and adverse events. Secondary endpoints were course of symptoms and therapy as well as patient satisfaction.

Results Mean follow-up was 22.1 ± 21.5 months. Average patient age was 31.7 ± 16.3 years. Localization: Most atypical OO (61 %) were located in the lower extremity, followed by axial skeleton (26 %) and upper extremity (13 %). Pain anamnesis: 74 % of patients stated that their pain occured predominantly at night and responded to NSAID, as typical for OO. Diagnostics: Patients consulted on average 4 different doctors and in 52 % patients, ≥ 3 different radiologic imaging techniques where used before the diagnosis “OO” was made. Outcome: Technical success of thermal ablation was 100 %. Primary clinical success was 91 %. Patient satisfaction was 100 %. No major complications occurred.

Conclusion In ¼ of cases, atypical OO did not show the typical pain characteristics of OO. Image-guided thermal ablation is a promising and safe therapy also for patients with atypical OO.

Key points:

  • Atypical OO are challenging regarding diagnostics and therapy

  • Image-guided thermal ablation is a safe and effective procedure also for patients with atypical OO

  • Image-guided thermal ablation shows high patient satisfaction

Citation Format

  • Seemann RJ, Märdian S, Schwabe P et al. Atypically Located Osteoid Osteoma: Characteristics and Therapeutic Success After Image-Guided Thermal Ablation. Fortschr Röntgenstr 2020; 192: 335 – 342