Effect of Rofecoxib on Pain Caused by Osteoid Osteoma

Abstract

In a prospective study, nine patients with osteoid osteoma were treated with a selective cyclooxygenase-2 inhibitor (rofecoxib). Patient pain perception with no treatment, with conventional nonsteroidal anti-inflammatory drug (NSAID) treatment, and with rofecoxib therapy was compared using a visual analog scale. Tumor response was also monitored by radiographs, computed tomography, and bone scintigraphy. In all cases, pain diminished on administration of rofecoxib in comparison to conventional NSAIDs (P<.05). Four patients underwent surgery whereas in the remaining five patients, bone scintigraphy showed reduced uptake after 6 months. In four patients who were retested at 12 months, scintigraphy values were normal. These four patients are currently asymptomatic and are not receiving any treatment, whereas the fifth patient is still receiving therapy.

Osteoid osteoma mimicking Brodie's abscess in a 13‐year‐old girl

“…8 Although conservative management with continued non-steroidal antiinflammatory therapy may be effective, the adverse effects associated with the chronic use of non-steroidal anti-inflammatory medication limit its use as definitive treatment. 9 Complete removal of the nidus results in immediate pain relief and healing of surrounding bone as in the present case. In superficial, easy to access, lesions as in the current case, conventional surgical removal remains a good option.…”

Osteoid osteoma: Contemporary management

“…Use of aspirin or other nonsteroidal anti-inflammatory medications (NSAIDs) decreases this time to 2 to 3 years. 42 , 43 Use of this nonoperative treatment option risks the potential side effects of protracted NSAID treatment. In anatomical areas where osteoid osteoma is not easily accessible surgically, this may be a viable treatment option.…”

Cortical Osteoid Osteomas of the Calcaneus Managed by En Bloc Resection and Autogenous Iliac Bone Grafting

“…There are different modalities for the treatment of osteoid osteomas including medical treatment with non-steroidal anti-inflammatory [8,9], surgical treatment including wide en bloc resection and unroofing with excision [9][10][11], also the minimally invasive surgical techniques including many surgical options as radionuclide-guided excision [12][13][14][15], CT-guided percutaneous excision [16,17], percutaneous laser photocoagulation [18,19], percutaneous radiofrequency coagulation [20,21] and computer-assisted surgery [22,23]. As regarding the medical treatment there were studies about the success of this modality within a period varying from 3 to 5 years with continuous use of nonsteroidal anti-inflammatory [8,9]. The problems encountered with this method include the need of prolonged period of treatment with its hazardous side effects (CNS, hepato-renal toxicity, gastritis and peptic ulcer) especially in young active peoples who will not accept this long period of treatment with it's adverse side effects [8,9].…”

“…As regarding the medical treatment there were studies about the success of this modality within a period varying from 3 to 5 years with continuous use of nonsteroidal anti-inflammatory [8,9]. The problems encountered with this method include the need of prolonged period of treatment with its hazardous side effects (CNS, hepato-renal toxicity, gastritis and peptic ulcer) especially in young active peoples who will not accept this long period of treatment with it's adverse side effects [8,9]. The open surgical treatments of osteoid osteoma include two main techniques which are wide en bloc resection and unroofing with excision with or without prophylactic internal fixation and grafting [10].…”