BACKGROUND Osteoid osteoma is a benign bone tumor with characteristic clinical symptomatology.The selected method for its treatment is percutaneous radiofrequency ablation.However,percutaneous cryoablation is an alter...BACKGROUND Osteoid osteoma is a benign bone tumor with characteristic clinical symptomatology.The selected method for its treatment is percutaneous radiofrequency ablation.However,percutaneous cryoablation is an alternative method with certain advantages.AIM To evaluate percutaneous computed tomography(CT)-guided cryoablation for the treatment of osteoid osteoma in young patients and adults.METHODS A total of 25 patients were treated with percutaneous CT-guided cryoablation for osteoid osteomas between October 2020 and March 2023 at a single institution.All patients were above 14-years-old(mean age,24-years-old),and all procedures were performed under local anesthesia.Of the 25 patients,8 were female and 17 were male.Tumor sites included the femur(n=9),medial malleolus(n=4),sacral ala(n=4),facets(n=4),humerus(n=3),and tibia(n=1).One cryoprobe was used in each procedure and,when possible,the lesion was covered by the ice-ball using an extraosseous position without penetrating the nidus.All necessary thermal protective techniques were used depending on the anatomical structure at risk.RESULTS All patients treated had complete response(100%clinical success rate)starting on the day of the procedure.Technical success was achieved in all cases.Visual analog scale(VAS)scores at 1 year were 0,compared to a mean VAS score of 8.5±1(SD)before the procedure.No recurrences were reported at the 1-year follow-up and no complications were observed.In 11/25 cases,an extraosseous position of the cryoprobe was used with less procedural time achieving technical and clinical success and no complications with less patient discomfort.All patients were discharged from the hospital on the same day as the procedure.CONCLUSION Cryoablation of osteoid osteomas is an efficacious and safe procedure with durable clinical results.Its greatest advantage is that the procedure can be performed under local anesthesia using an extraosseous position of the cryoprobe when possible.展开更多
Osteoid osteoma of the foot can be difficult to diagnose, the clinical presentation may be mimicking other local pathologies leading to a considerable delay in diagnosis. We report an exceptional localization of osteo...Osteoid osteoma of the foot can be difficult to diagnose, the clinical presentation may be mimicking other local pathologies leading to a considerable delay in diagnosis. We report an exceptional localization of osteoid osteoma in the second metatarsal in a 30-year-old patient, expressed for 3 years by metatarsalgia, with no clinical and radiological architecture defect of the foot. After discovering the nidus, the patient underwent surgical excision with an excellent outcome.展开更多
Study design: Description of a technique through a case-series. Objective: To promote a technique by using a gamma probe that asses intraoperatively the adequacy of the lesion curettage through a minimal invasive proc...Study design: Description of a technique through a case-series. Objective: To promote a technique by using a gamma probe that asses intraoperatively the adequacy of the lesion curettage through a minimal invasive procedure. Methods: Reviewing the technique steps through 4 cases of osteoid osteoma surgical removal. Results: Four patients diagnosed with osteoid osteoma and moved to surgical removal. During the operation, excision of the tumour was assessed by a gamma probe, avoiding leaving residual lesion in the field. Operating time was not prolonged, so as the cost of the operation was not increased. Conclusions: Surgical excision of osteoid osteoma in spine region is still the gold standard method. Avoiding recurrence of the lesion is important. The use of gamma probe is an effective and economic solution.展开更多
AIM:To present our initial experience with computed tomography guided radiofrequency ablation(RFA) of osteoid osteoma(OO) in our institution.METHODS:RFA was performed on eight patients(5 males and 3 females) with clin...AIM:To present our initial experience with computed tomography guided radiofrequency ablation(RFA) of osteoid osteoma(OO) in our institution.METHODS:RFA was performed on eight patients(5 males and 3 females) with clinically and radiologically diagnosed OO(femoral neck,n = 4;femoral diaphysis,n = 2;tibial diaphysis,n = 1;fibular diaphysis,n = 1).Ablation was performed using an electrode with a 10-mm exposed tip for a total of 4-6 min at a targeted temperature of 90 degrees Celsius.No cooling system was used.The intervention was accepted as technically successful if the tip of the electrode could be placed within the center of the nidus.We defined clinical success as a disappearance within 2 wk after treatment of symptoms that had manifested at presentation.RESULTS:All procedures were technically successful.No major or immediate complications were observed.Clinical success was achieved in six of eight patients in the first procedure.A second procedure was performed for two patients who had recurrent or continued pain,and one of these cases was successfully treated.The overall rate of success was 87.5%(7/8).No complication was observed.CONCLUSION:Our preliminary results indicate a favorable success rate and no complications and are compatible with the previous reports of RFA of OO.展开更多
BACKGROUND Intra-articular osteoid osteoma(iaOO)can be found in 5.2%up to 10%of cases.They may cause non-specific symptoms,mimicking degenerative or traumatic pathologies.If iaOO is left untreated,it may lead to sever...BACKGROUND Intra-articular osteoid osteoma(iaOO)can be found in 5.2%up to 10%of cases.They may cause non-specific symptoms,mimicking degenerative or traumatic pathologies.If iaOO is left untreated,it may lead to severe muscle atrophy,tenderness,swelling,and limited range of motion.Therefore,surgical treatment is recommended.The main goal of surgical treatment is complete removal or destruction of iaOO.AIM To evaluate the efficiency of arthroscopic removal of iaOO of the knee in our cases and cases available in the literature.METHODS Analysis of available hospital records of four patients with iaOO of the knee treated by arthroscopic removal from August 2005 to December 2015 at our Department was performed.All patients had a diagnosis of iaOO confirmed by histopathologic analysis.Additional literature review of cases of iaOO of the knee available on PubMed and Google Scholar was made.All cases of iaOO of the knee treated by arthroscopic or arthroscopically assisted removal were reviewed in order to further evaluate the efficiency of the method.RESULTS The average age of patients included in our study was 23.2(range 16-37)years.The average duration of the symptoms prior to surgery was 14.2(range 6-24)months.All of the patients had persistent knee pain.Three patients reported worsening of pain during the night,while two reported worsening of pain during activity.Three patients reported alleviation of pain on non-steroidal anti-inflammatory drugs(NSAIDs),while one patient reported partial alleviation of pain on NSAIDs.No intraoperative complications were noted,and the postoperative period was uneventful in all patients.The patients reported immediate pain relief in the postoperative period.No recurrence of the disease was noted in any of the patients during the follow-up period of at least 24 mo.The literature review revealed 14 cases with an average age of 27.6(range 16-48)years and onset of symptoms 27.7(range 6-108)months prior to surgery,with recurrence of the disease noted in a single case.CONCLUSION Arthroscopic removal is an efficient treatment method that allows excision of iaOO that is neither insufficient nor excessive,thus avoiding disease recurrence while obtaining adequate material for histopathologic analysis.展开更多
A case of osteoid osteoma of the elbow in a patient with hemophilia A is described. This male patient presented with chronic and nocturnal pain of the left elbow which was alleviated with acetaminophen. Besides pain, ...A case of osteoid osteoma of the elbow in a patient with hemophilia A is described. This male patient presented with chronic and nocturnal pain of the left elbow which was alleviated with acetaminophen. Besides pain, he also complained of stiffness. Before these complaints, he had recurrent bleedings in the elbow because of hemophilia. A delayed diagnosis of osteoid osteoma in the proximal part of the left ulna was established by a bone scan and a multislice spiral computed tomography(CT) scan. The lesion was surgically removed under CT-guidance. The histopathological analyses did not show specific features of osteoid osteoma. Two months after the operation, the complaints decreased and the range of motion of the left elbow improved. A diagnosis of osteoid osteoma of the elbow should be considered in young adult patients with persistent elbow pain and histological confirmation is not always necessary.展开更多
Osteoid osteoma is a benign bone tumor that is commonly seen in males in their second and third decade of life. The tumor commonly occurs in long bones (proximal femur and tibia) and rarely in the spine, hands and fee...Osteoid osteoma is a benign bone tumor that is commonly seen in males in their second and third decade of life. The tumor commonly occurs in long bones (proximal femur and tibia) and rarely in the spine, hands and feet. It presents with bone pain worsening at night and responds well to nonsteroidal anti-inflammatory drugs. It is usually treated conservatively but sometimes with surgery if medical treatment fails. We present a case of 19-year-old girl, who presented with mild pain over lateral aspect of right ankle for 6 months duration. The pain was provoked by sporting activities, and was initially relieved by analgesics, until recently, hence her presentation. CT scan was done and showed a well-defined central nodule of bone. She had an open excisional biopsy, and the histology showed a diagnosis of osteoid osteoma. Post-operative healing was uneventful, the fracture united after 6 weeks and she was able to ambulate without any pain 3 months post-surgery.展开更多
Osteoid osteoma is a benign bone forming tumor of the growing skeleton that is most often seen in young men. It represents by pain and radiologic appearance of anidus surrounded by osteosclerosisthat occurs mostly in ...Osteoid osteoma is a benign bone forming tumor of the growing skeleton that is most often seen in young men. It represents by pain and radiologic appearance of anidus surrounded by osteosclerosisthat occurs mostly in long bones of the lower extremity. Occurrence of this tumor in the hand is an uncommon condition. We present a 23-year-old man with an osteoid osteoma in the proximal phalanx of the right index finger. The radiological examination showed a lytic lesion with irregular border with a central sclerotic nidus and also sclerotic changes around the lytic lesion and bone expansion in the proximal phalanx of the right index finger. He was suffering from a history of pain and swelling of his finger since 8 months. The pain disappeared after surgical excision of nidus. The patient was pain-free and there was no evidence of recurrence at 15 months follow up.展开更多
Objective To report the results of treatment of osteoid osteomas with wide surgical excision and CT-guided less invasive surgeries.Methods Forty-two patients were entered into this prospective study between Jan.1998 a...Objective To report the results of treatment of osteoid osteomas with wide surgical excision and CT-guided less invasive surgeries.Methods Forty-two patients were entered into this prospective study between Jan.1998 and Jan.2008.Nineteen patients underwent wide surgical excision.The lesions were in the femur(n=9),tibia(n=7),and humerus(n=3).The mean lesion diameter was(9.2±2.3)mm(range,7-16mm).Twenty-three patients(15 males and 8 females)underwent CT-guided less invasive surgeries procedures.The lesions were in the femur(n=9),tibia(n=6),acetabulum(n=4)and humerus(n=4).The mean lesion diameter was(8.1±2.7)mm(range,6-15mm).Among these 23 patients,20 patients were performed by core drill excision.Three patients were performed by radiofrequency ablation.Follow-up ranged from 16 to 68 months(mean,35 months)to assess pain,neurovascular damage,pathological fracture,movement,and recurrence.Results were categorized as success(persistent complete relief of pain)and failure(absent or incomplete relief of pain,requiring additional treatment).Results The success rates were 89%(17/19)after wide surgical excision and 96%(22/23)after less invasive surgeries,respectively,and the difference was not significant(P>0.05).Patients were hospitalized for average 8.3 d(5-15d)after wide surgical excision and 3.2d(3-5d)after less invasive surgeries(P<0.05).There were no complications such as sepsis,pathological fracture,or neurovascular damage.No further recurrences were observed during follow-up.Conclusion Less invasive surgeries has obvious advantages such as reduced cost,shorter stay in hospital and rapid convalescence.Core-drill excision can obtain sufficient material for pathologic examination.展开更多
Osteoid osteoma is very rarely located in the patella, and can represent a significant diagnostic challenge, resulting in a delay of treatment. Patients with osteoid osteoma of the patella often present with knee pain...Osteoid osteoma is very rarely located in the patella, and can represent a significant diagnostic challenge, resulting in a delay of treatment. Patients with osteoid osteoma of the patella often present with knee pain that is also a typical symptom of trauma or of other diseases such as arthritis, which are much more common than osteoid osteoma. We present two young male patients diagnosed with osteoid osteoma of the patella. Each of these patients had a history of intense knee pain; however, accurate diagnosis of osteoid osteoma in the patella had been delayed for more than one year. Computed tomography （CT） scans or magnetic resonance imaging （MRI） showed a circumscribed lesion of the patella in both patients, whereas X-ray examination （posteroantedor projection） was not able to detect the tumor. Different surgical procedures were performed in these patients for resection of the tumors, and the pathology findings confirmed the diagnosis of osteoid osteoma. Both patients recovered completely from surgery.展开更多
A 34-year-old man with a subtrochanteric osteoid osteoma localized to the lateral cortex of the left femur is reported. The patient presented with mild spontaneous pain of the lateral thigh and knee. He refused a radi...A 34-year-old man with a subtrochanteric osteoid osteoma localized to the lateral cortex of the left femur is reported. The patient presented with mild spontaneous pain of the lateral thigh and knee. He refused a radiographic examination and was treated as a greater trochanteric pa in syndrome for 9 months. He was then admitted with a transcervical fracture of the neck of the left femur after a fall from standing height. The fracture was fixed with 3 cannulated screws and healed uneventfully. His symptoms worsened after the first postoperative year. Eighteen months postoperatively the pain was dull, worsening at night, and relieved only with anti-inflammatory drugs, and he had a limp. New radiographs and tomograms were indicative of a lateral subtrochanteric osteoid osteoma with a subperiosteal localization. The lesion was treated successfully with surgical excision of a piece of reactive bone including the nidus.展开更多
Background This study evaluated the feasibility, efficacy and safety of CT-guided percutaneous radiofrequency ablation in patients with spinal osteoid osteoma. Methods Two patients suffered spinal osteoid osteoma were...Background This study evaluated the feasibility, efficacy and safety of CT-guided percutaneous radiofrequency ablation in patients with spinal osteoid osteoma. Methods Two patients suffered spinal osteoid osteoma were treated with CT-guided percutaneous radiofrequency ablation under local anesthesia. Lesions located in sacral vertebrae and cervical vertebrae, which were adjacent to nerve root and spinal canal respectively. Tumors were treated under 90℃ radiofrequency temperature lasting 4 minutes by an electrode placement. Visual analog scale was used to evaluate the pain improvement. Results No complications were observed pre- and post-operation. Patients recovered to normal activities immediately and achieved complete pain relief in 24 hours. No symptoms were recurrent in 5 months and 4 months follow up. Mild scoliosis has been recovered in case 2. Conclusions CT-guided percutaneous radiofrequency ablation of spinal osteoid osteoma is safe, effective and has more clinical benefits. The long-term outcome needs further observation.展开更多
目的回顾性分析射频消融和开放手术治疗儿童股骨骨样骨瘤的临床效果。方法选择2010-04至2023-02首都医科大学附属北京儿童医院骨科收治的股骨骨样骨瘤(术后病理证实)患者24例,其中射频消融组11例(男8例,女3例),开放手术组13例(男9例,女4...目的回顾性分析射频消融和开放手术治疗儿童股骨骨样骨瘤的临床效果。方法选择2010-04至2023-02首都医科大学附属北京儿童医院骨科收治的股骨骨样骨瘤(术后病理证实)患者24例,其中射频消融组11例(男8例,女3例),开放手术组13例(男9例,女4例),收集患者临床资料包括年龄,性别,随访时间,术前,术后3 d和末次随访疼痛评分,手术时长,住院时长,出血量,术中CT扫描次数;影像资料包括术前瘤体直径及末次随访有无复发灶。对比治疗效果。结果射频消融组和开放手术组患者手术出血量分别为(1.73±1.19)ml和(12.31±5.99)ml,住院时长分别为(8.27±1.27)d和(12.23±1.88)d,术中CT扫描次数分别为(1.64±0.81)次和(0.31±0.48)次,术后3 d VAS评分分别为(1.73±0.65)和(3.62±0.87),上述差异均有统计学意义(P<0.05)。射频消融组有1例发生轻度热损伤,开放手术组有1例术后复发。结论与开放手术相比,射频消融治疗儿童股骨骨样骨瘤有出血少、住院时间短,疼痛症状缓解快等优点,值得推广,但应注意避免热损伤的发生。展开更多
基金approved by the Institutional Review Board of General Hospital of Thessaloniki“G.Papanikolaou”(Protocol Code 77481-12 and 05-04-2024).
文摘BACKGROUND Osteoid osteoma is a benign bone tumor with characteristic clinical symptomatology.The selected method for its treatment is percutaneous radiofrequency ablation.However,percutaneous cryoablation is an alternative method with certain advantages.AIM To evaluate percutaneous computed tomography(CT)-guided cryoablation for the treatment of osteoid osteoma in young patients and adults.METHODS A total of 25 patients were treated with percutaneous CT-guided cryoablation for osteoid osteomas between October 2020 and March 2023 at a single institution.All patients were above 14-years-old(mean age,24-years-old),and all procedures were performed under local anesthesia.Of the 25 patients,8 were female and 17 were male.Tumor sites included the femur(n=9),medial malleolus(n=4),sacral ala(n=4),facets(n=4),humerus(n=3),and tibia(n=1).One cryoprobe was used in each procedure and,when possible,the lesion was covered by the ice-ball using an extraosseous position without penetrating the nidus.All necessary thermal protective techniques were used depending on the anatomical structure at risk.RESULTS All patients treated had complete response(100%clinical success rate)starting on the day of the procedure.Technical success was achieved in all cases.Visual analog scale(VAS)scores at 1 year were 0,compared to a mean VAS score of 8.5±1(SD)before the procedure.No recurrences were reported at the 1-year follow-up and no complications were observed.In 11/25 cases,an extraosseous position of the cryoprobe was used with less procedural time achieving technical and clinical success and no complications with less patient discomfort.All patients were discharged from the hospital on the same day as the procedure.CONCLUSION Cryoablation of osteoid osteomas is an efficacious and safe procedure with durable clinical results.Its greatest advantage is that the procedure can be performed under local anesthesia using an extraosseous position of the cryoprobe when possible.
文摘Osteoid osteoma of the foot can be difficult to diagnose, the clinical presentation may be mimicking other local pathologies leading to a considerable delay in diagnosis. We report an exceptional localization of osteoid osteoma in the second metatarsal in a 30-year-old patient, expressed for 3 years by metatarsalgia, with no clinical and radiological architecture defect of the foot. After discovering the nidus, the patient underwent surgical excision with an excellent outcome.
文摘Study design: Description of a technique through a case-series. Objective: To promote a technique by using a gamma probe that asses intraoperatively the adequacy of the lesion curettage through a minimal invasive procedure. Methods: Reviewing the technique steps through 4 cases of osteoid osteoma surgical removal. Results: Four patients diagnosed with osteoid osteoma and moved to surgical removal. During the operation, excision of the tumour was assessed by a gamma probe, avoiding leaving residual lesion in the field. Operating time was not prolonged, so as the cost of the operation was not increased. Conclusions: Surgical excision of osteoid osteoma in spine region is still the gold standard method. Avoiding recurrence of the lesion is important. The use of gamma probe is an effective and economic solution.
文摘AIM:To present our initial experience with computed tomography guided radiofrequency ablation(RFA) of osteoid osteoma(OO) in our institution.METHODS:RFA was performed on eight patients(5 males and 3 females) with clinically and radiologically diagnosed OO(femoral neck,n = 4;femoral diaphysis,n = 2;tibial diaphysis,n = 1;fibular diaphysis,n = 1).Ablation was performed using an electrode with a 10-mm exposed tip for a total of 4-6 min at a targeted temperature of 90 degrees Celsius.No cooling system was used.The intervention was accepted as technically successful if the tip of the electrode could be placed within the center of the nidus.We defined clinical success as a disappearance within 2 wk after treatment of symptoms that had manifested at presentation.RESULTS:All procedures were technically successful.No major or immediate complications were observed.Clinical success was achieved in six of eight patients in the first procedure.A second procedure was performed for two patients who had recurrent or continued pain,and one of these cases was successfully treated.The overall rate of success was 87.5%(7/8).No complication was observed.CONCLUSION:Our preliminary results indicate a favorable success rate and no complications and are compatible with the previous reports of RFA of OO.
文摘BACKGROUND Intra-articular osteoid osteoma(iaOO)can be found in 5.2%up to 10%of cases.They may cause non-specific symptoms,mimicking degenerative or traumatic pathologies.If iaOO is left untreated,it may lead to severe muscle atrophy,tenderness,swelling,and limited range of motion.Therefore,surgical treatment is recommended.The main goal of surgical treatment is complete removal or destruction of iaOO.AIM To evaluate the efficiency of arthroscopic removal of iaOO of the knee in our cases and cases available in the literature.METHODS Analysis of available hospital records of four patients with iaOO of the knee treated by arthroscopic removal from August 2005 to December 2015 at our Department was performed.All patients had a diagnosis of iaOO confirmed by histopathologic analysis.Additional literature review of cases of iaOO of the knee available on PubMed and Google Scholar was made.All cases of iaOO of the knee treated by arthroscopic or arthroscopically assisted removal were reviewed in order to further evaluate the efficiency of the method.RESULTS The average age of patients included in our study was 23.2(range 16-37)years.The average duration of the symptoms prior to surgery was 14.2(range 6-24)months.All of the patients had persistent knee pain.Three patients reported worsening of pain during the night,while two reported worsening of pain during activity.Three patients reported alleviation of pain on non-steroidal anti-inflammatory drugs(NSAIDs),while one patient reported partial alleviation of pain on NSAIDs.No intraoperative complications were noted,and the postoperative period was uneventful in all patients.The patients reported immediate pain relief in the postoperative period.No recurrence of the disease was noted in any of the patients during the follow-up period of at least 24 mo.The literature review revealed 14 cases with an average age of 27.6(range 16-48)years and onset of symptoms 27.7(range 6-108)months prior to surgery,with recurrence of the disease noted in a single case.CONCLUSION Arthroscopic removal is an efficient treatment method that allows excision of iaOO that is neither insufficient nor excessive,thus avoiding disease recurrence while obtaining adequate material for histopathologic analysis.
文摘A case of osteoid osteoma of the elbow in a patient with hemophilia A is described. This male patient presented with chronic and nocturnal pain of the left elbow which was alleviated with acetaminophen. Besides pain, he also complained of stiffness. Before these complaints, he had recurrent bleedings in the elbow because of hemophilia. A delayed diagnosis of osteoid osteoma in the proximal part of the left ulna was established by a bone scan and a multislice spiral computed tomography(CT) scan. The lesion was surgically removed under CT-guidance. The histopathological analyses did not show specific features of osteoid osteoma. Two months after the operation, the complaints decreased and the range of motion of the left elbow improved. A diagnosis of osteoid osteoma of the elbow should be considered in young adult patients with persistent elbow pain and histological confirmation is not always necessary.
文摘Osteoid osteoma is a benign bone tumor that is commonly seen in males in their second and third decade of life. The tumor commonly occurs in long bones (proximal femur and tibia) and rarely in the spine, hands and feet. It presents with bone pain worsening at night and responds well to nonsteroidal anti-inflammatory drugs. It is usually treated conservatively but sometimes with surgery if medical treatment fails. We present a case of 19-year-old girl, who presented with mild pain over lateral aspect of right ankle for 6 months duration. The pain was provoked by sporting activities, and was initially relieved by analgesics, until recently, hence her presentation. CT scan was done and showed a well-defined central nodule of bone. She had an open excisional biopsy, and the histology showed a diagnosis of osteoid osteoma. Post-operative healing was uneventful, the fracture united after 6 weeks and she was able to ambulate without any pain 3 months post-surgery.
文摘Osteoid osteoma is a benign bone forming tumor of the growing skeleton that is most often seen in young men. It represents by pain and radiologic appearance of anidus surrounded by osteosclerosisthat occurs mostly in long bones of the lower extremity. Occurrence of this tumor in the hand is an uncommon condition. We present a 23-year-old man with an osteoid osteoma in the proximal phalanx of the right index finger. The radiological examination showed a lytic lesion with irregular border with a central sclerotic nidus and also sclerotic changes around the lytic lesion and bone expansion in the proximal phalanx of the right index finger. He was suffering from a history of pain and swelling of his finger since 8 months. The pain disappeared after surgical excision of nidus. The patient was pain-free and there was no evidence of recurrence at 15 months follow up.
文摘Objective To report the results of treatment of osteoid osteomas with wide surgical excision and CT-guided less invasive surgeries.Methods Forty-two patients were entered into this prospective study between Jan.1998 and Jan.2008.Nineteen patients underwent wide surgical excision.The lesions were in the femur(n=9),tibia(n=7),and humerus(n=3).The mean lesion diameter was(9.2±2.3)mm(range,7-16mm).Twenty-three patients(15 males and 8 females)underwent CT-guided less invasive surgeries procedures.The lesions were in the femur(n=9),tibia(n=6),acetabulum(n=4)and humerus(n=4).The mean lesion diameter was(8.1±2.7)mm(range,6-15mm).Among these 23 patients,20 patients were performed by core drill excision.Three patients were performed by radiofrequency ablation.Follow-up ranged from 16 to 68 months(mean,35 months)to assess pain,neurovascular damage,pathological fracture,movement,and recurrence.Results were categorized as success(persistent complete relief of pain)and failure(absent or incomplete relief of pain,requiring additional treatment).Results The success rates were 89%(17/19)after wide surgical excision and 96%(22/23)after less invasive surgeries,respectively,and the difference was not significant(P>0.05).Patients were hospitalized for average 8.3 d(5-15d)after wide surgical excision and 3.2d(3-5d)after less invasive surgeries(P<0.05).There were no complications such as sepsis,pathological fracture,or neurovascular damage.No further recurrences were observed during follow-up.Conclusion Less invasive surgeries has obvious advantages such as reduced cost,shorter stay in hospital and rapid convalescence.Core-drill excision can obtain sufficient material for pathologic examination.
文摘Osteoid osteoma is very rarely located in the patella, and can represent a significant diagnostic challenge, resulting in a delay of treatment. Patients with osteoid osteoma of the patella often present with knee pain that is also a typical symptom of trauma or of other diseases such as arthritis, which are much more common than osteoid osteoma. We present two young male patients diagnosed with osteoid osteoma of the patella. Each of these patients had a history of intense knee pain; however, accurate diagnosis of osteoid osteoma in the patella had been delayed for more than one year. Computed tomography （CT） scans or magnetic resonance imaging （MRI） showed a circumscribed lesion of the patella in both patients, whereas X-ray examination （posteroantedor projection） was not able to detect the tumor. Different surgical procedures were performed in these patients for resection of the tumors, and the pathology findings confirmed the diagnosis of osteoid osteoma. Both patients recovered completely from surgery.
文摘A 34-year-old man with a subtrochanteric osteoid osteoma localized to the lateral cortex of the left femur is reported. The patient presented with mild spontaneous pain of the lateral thigh and knee. He refused a radiographic examination and was treated as a greater trochanteric pa in syndrome for 9 months. He was then admitted with a transcervical fracture of the neck of the left femur after a fall from standing height. The fracture was fixed with 3 cannulated screws and healed uneventfully. His symptoms worsened after the first postoperative year. Eighteen months postoperatively the pain was dull, worsening at night, and relieved only with anti-inflammatory drugs, and he had a limp. New radiographs and tomograms were indicative of a lateral subtrochanteric osteoid osteoma with a subperiosteal localization. The lesion was treated successfully with surgical excision of a piece of reactive bone including the nidus.
文摘Background This study evaluated the feasibility, efficacy and safety of CT-guided percutaneous radiofrequency ablation in patients with spinal osteoid osteoma. Methods Two patients suffered spinal osteoid osteoma were treated with CT-guided percutaneous radiofrequency ablation under local anesthesia. Lesions located in sacral vertebrae and cervical vertebrae, which were adjacent to nerve root and spinal canal respectively. Tumors were treated under 90℃ radiofrequency temperature lasting 4 minutes by an electrode placement. Visual analog scale was used to evaluate the pain improvement. Results No complications were observed pre- and post-operation. Patients recovered to normal activities immediately and achieved complete pain relief in 24 hours. No symptoms were recurrent in 5 months and 4 months follow up. Mild scoliosis has been recovered in case 2. Conclusions CT-guided percutaneous radiofrequency ablation of spinal osteoid osteoma is safe, effective and has more clinical benefits. The long-term outcome needs further observation.
文摘目的回顾性分析射频消融和开放手术治疗儿童股骨骨样骨瘤的临床效果。方法选择2010-04至2023-02首都医科大学附属北京儿童医院骨科收治的股骨骨样骨瘤(术后病理证实)患者24例,其中射频消融组11例(男8例,女3例),开放手术组13例(男9例,女4例),收集患者临床资料包括年龄,性别,随访时间,术前,术后3 d和末次随访疼痛评分,手术时长,住院时长,出血量,术中CT扫描次数;影像资料包括术前瘤体直径及末次随访有无复发灶。对比治疗效果。结果射频消融组和开放手术组患者手术出血量分别为(1.73±1.19)ml和(12.31±5.99)ml,住院时长分别为(8.27±1.27)d和(12.23±1.88)d,术中CT扫描次数分别为(1.64±0.81)次和(0.31±0.48)次,术后3 d VAS评分分别为(1.73±0.65)和(3.62±0.87),上述差异均有统计学意义(P<0.05)。射频消融组有1例发生轻度热损伤,开放手术组有1例术后复发。结论与开放手术相比,射频消融治疗儿童股骨骨样骨瘤有出血少、住院时间短,疼痛症状缓解快等优点,值得推广,但应注意避免热损伤的发生。
