Successful percutaneous treatment of osteoid osteoma in a 13 month-old boy with radiofrequency ablation under CT guidance

Abstract

We present a 13-month-old boy who had a successful Computed Tomography (CT) guided percutaneous radiofrequency ablation (RFA) treatment for the osteoid osteoma (OO) on proximal part of the tibial diaphysis. The complaints of the patient were being restless due to pain and refusing to bear any weight on his left leg for 6 months. An asymmetrical cortical thickening and a focal sclerosis was detected on medial proximal diaphysis of the left tibia on radiographs and axial T2-weighted STIR-MR image showed bone marrow and soft-tissue edema with low-signal-intensity nidus due to central calcification with a high-signal-intensified unmineralized periphery. CT findings (the nidus on the cortex of tibia with well circumscribed lucent region around a central sclerotic dot and cortical thickening around the nidus) confirmed the diagnosis of OO. After CT guided percutaneous RFA treatment, the patient had an immediate pain relief in 24 h after and could bear weight on the leg. 12 and 16 months after RFA respectively, CT images and radiographs revealed sclerotic healing of the nidus and a slow regression of the adjacent cortical thickness without any recurrence.

Secondary radiological findings of osteoid osteoma as muscular atrophy and synovitis in paediatric and adult patients

“…One of them is the age of the patients -most of the patients were of paediatric age, hence MRI was preferred due to being radiation-free. Second, since the diagnosis of OO is very hard and malignant tumours and osteomyelitis are in the differential diagnosis list, MRI was preferred as the first cross-sectional imaging modality because it is superior for the visualisation of soft tissue pathologies and masses, compared to CTI [4,6]. Another reason is that MRI is superior in visualising bone marrow oedema [6].…”

“…Osteoid osteoma (OO) is a benign osteogenic tumour that commonly affects male gender in second decade of life [1][2][3][4]. Diagnosis is based on characteristic clinical and radiological findings.…”

Intramedullary osteoid osteoma in the humerus of a toddler—A case report and review of the literature

“…We conducted a retrospective literature review and summarized 15 cases of OO in children younger than 5 years ( Table 1 ) [ 16 , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] ]. The male/female ratio was 7:3, and all the tumors were located in the lower extremities, similar to the clinical features of typical adult cases of OO.…”

The safety and the efficacy of computed tomography guided percutaneous radiofrequency ablation of osteoid osteoma

“…Percutaneous RFA-treatment is an outpatient procedure that does not require large dissections or bone excisions. This makes percutaneous interventional treatments advantageous 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 17, 18, 20, 21. Since the most of our patients were admitted from far-cities, we hospitalised them for one night for close follow-up of possible complications.…”

“…The ablation time was 7 min and the temperature of the RFA-electrode was increased to a maximum of 90° in all the patients while time was 5 min and temperature was 80° in this 13-month-old-boy. We have published this youngest, 13-month-old, patient as a case report 17 Fig.…”