Preoperative localization of osteoid osteoma: a new technique that uses CT.

Radiofrequency Ablation of Osteoid Osteoma in the Upper Extremity

“…14 The former study attributed recurrences to inadequate bone excision and recommended techniques for complete yet conservative excision in such small areas including intraoperative radionuclide localization 15 and preoperative CT-guided needle localization. 16 The CTguided RFA technique obviously affords this precision; however, there is only 1 RFA study that includes lesions of the hand and carpus. 6 That study of 97 lesions throughout the skeleton included 8 lesions of the hand and carpus but no procedural considerations, outcomes, or complications specific to those locations were reported other than the fact that 3 of these patients went on to have residual or recurrent symptoms.…”

Osteoid Osteoma of the Spine Treated With Percutaneous Computed Tomography–Guided Thermocoagulation

“…3 Preoperative CT-guided marking of the lesion and CT-guided excision has been advocated. 7,8,10,18 Because of the large size of the drill and cores used, this is a procedure that still causes significant tissue damage.…”

“…A less invasive technique involving computed tomographic (CT) guidance has been advocated. 7,8,10,18 These case reports describe a percutaneous technique with thermocoagulation aided by CT guidance that was used in two patients with an osteoid osteoma of the lumbar spine.…”

CT-guided percutaneous drilling is a safe and reliable method of treating osteoid osteomas

“…The difficulties in treating osteoid osteomas lie in the intra-surgical pinpointing of the tumor and the mechanical precariousness of the remaining bone after resection (Steinberg et al 1990). Total resection must be achieved to avoid relapse and assure pain relief (Norman 1978).…”

“…Total resection must be achieved to avoid relapse and assure pain relief (Norman 1978). Because not all osteoid osteomas can be visualized with the image intensifier, one proposed solution was to pinpoint its location prior to resection using a computed tomography (CT) scan and mark it with a Kirschner wire, which could then be easily found at the time of surgery (David et al 1997, Steinberg et al 1990). Another possibility was to use a radioactive tracer with bone tropism (Pratali et al 2009).…”