Osteoid osteoma is a benign (non-cancerous) bone tumor that mainly affects young people, usually between 10 and 30 years old. It represents approximately 10% of all benign bone tumors. Although osteoid osteomas can occur in any bone, they are most commonly found in the long bones of the lower extremities, such as the femur or tibia.
Symptoms:
Symptom of osteoid osteoma is persistent pain; it may be sharp or aching.
The pain tends to worsen at night and is usually relieved by non-prescription anti-inflammatory drugs like aspirin or ibuprofen.
Causes:
The exact cause of osteoid osteoma is not well understood. However, it is often considered a neoplastic condition (involving tumor formation). Some factors that may contribute to the development of osteoid osteoma include:
- Genetic Factors: Osteoid osteoma may pass on from one generation to the other .However, no specific genetic mutations have been consistently linked to the condition.
- Vascular: Some theories propose that osteoid osteomas may be related to abnormalities in the blood vessels within the bone. These vascular abnormalities could contribute to the formation of nidus (abnormal bone tissue).
- Inflammatory Response: Osteoid osteomas are often associated with a strong inflammatory response in the surrounding bone tissue. This inflammatory reaction is thought to contribute to the pain associated with the tumor. The exact relationship between inflammation and the initiation of osteoid osteoma is not fully understood.
- Trauma: While trauma has been suggested as a possible trigger for osteoid osteoma, it is a subject of debate. Some cases have been reported where the development of an osteoid osteoma followed a history of trauma to the affected bone. However, not all individuals with osteoid osteomas have a history of significant trauma.
Diagnosis of Osteoid Osteoma
Diagnosis of osteoid osteoma typically involves a combination of clinical evaluation, imaging studies, and sometimes additional diagnostic procedures. Below are the common steps involved in diagnosing osteoid osteoma:
Clinical Evaluation:
A thorough medical history is obtained, including information about the onset and characteristics of pain, exacerbating or alleviating factors, and any associated symptoms.
Physical examination helps assess localized tenderness and swelling.
Imaging Studies:
- X-rays: Initial imaging often involves plain X-rays of the affected area. Osteoid osteomas typically present as a radiolucent (dark) nidus surrounded by a sclerotic (dense) rim on X-ray images.
- Computed Tomography (CT) Scan: CT scans provide more detailed images and are often more sensitive in detecting the small nidus within the bone. CT is especially useful for precise localization and characterization of the lesion.
- Radionuclide Bone Scanning (Optional): In some cases, a bone scan may be performed. This involves injecting a small amount of radioactive material into the bloodstream, which is then absorbed by the bones. Areas of increased uptake may suggest the presence of an osteoid osteoma.
- Magnetic Resonance Imaging (MRI) (Optional): MRI may be used in certain cases, particularly when the diagnosis is uncertain or when evaluating soft tissues around the affected bone.
- Biopsy: While rare due to the characteristic imaging findings, a biopsy may be considered in certain cases where confirmation is crucial.
Treatment:
Medication - Nonsteroidal anti-inflammatory drugs (NSAIDs) are often prescribed to relieve pain.
In some cases, especially when conservative measures are ineffective or the tumor causes significant disability, interventional procedures may be considered.
Microwave Ablation - is a common, latest and effective treatment for osteoid osteomas. It involves using a needle-like probe to apply heat to the nidus, destroying the tumor tissue. It’s a day care procedure and patient are discharged with 24 hours without any cut or big surgery.
For more information contact your near by Intervention Radiologist or us.
