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Radiofrequency Ablation: A Minimally Invasive Treatment for Kids with Osteoid Osteoma

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While no parent wants to see their child suffer with long-term pain, this is sometimes a reality for parents of children with osteoid osteoma. Osteoid osteoma is a painful, benign bone tumor that occurs mostly in children. Although the condition can sometimes resolve on its own, that can take a long time while the child continues to experience painful symptoms. At UVA Radiology, we want parents to know about a minimally invasive, low-risk treatment option for these tumors called RF Ablation.

Article reviewed by Cody Quirk, MD


What is Osteoid Osteoma?

Osteoid osteoma is a benign (non-cancerous) bone tumor. Although these tumors are typically less than 2 cm in size, they can cause reactive bone to form around the tumor. Reactive bone is the body’s process of forming more bone along with a dense layer of connective tissue in response to the abnormal stimuli of the tumor. This also makes the condition more identifiable to radiologists reading bone images. Osteoid osteoma can be found on any bone in the body, but typically appear in the body’s lower region on the femur (thigh bone) or the tibia (shin bone).

Osteoid osteoma is typically found in children and young adults. While these tumors are small in size and do not spread to other parts of the body, they can cause a significant amount of pain. This can cause daily struggles for children such as not participating in physical activity or trouble sleeping due to aching bones.  

Symptoms

Symptoms range from moderate to severe including:

  • Inflammation around the tumor
  • Aching or throbbing pain in the area of the tumor
  • Pain worsening at night or with activity

Diagnosis

Diagnosis for osteoid osteoma begins with a doctor performing a physical exam before deciding whether to order more studies. Further studies may include:

X-ray: allow radiologists to see the bone structures and search for tumors. Tumors will appear in x-ray images as thickened bone surrounding a point of lower density.

CT Scan: allow radiologists to examine cross-sections of the bone to see the center of tumors.

Biopsy: a tissue sample of the tumor that is studied under a microscope. A biopsy may be taken to confirm the benign bone tumor. This sample may be collected using a needle while local anesthetic is sometimes given to numb the area surrounding the tumor.

Advantages of Radiofrequency Ablation

Sometimes these bone tumors will shrink on their own, but this can take up to seven years. The conservative treatment option for osteoid osteoma is over-the-counter anti-inflammatory, pain-relieving drugs such as ibuprofen, naproxen, or aspirin. But for more painful tumors, over-the-counter medicine may not be enough to control the pain while waiting years for the tumor to resolve on its own.

Surgical treatment is also an option, in which an incision is made in the skin and the benign tumor is scraped from the bone. It is very important to ensure the entire tumor and its core are completely removed so that it does not grow back. Sometimes surgery can also involve implantation of bone grafts. Unfortunately, traditional surgery has higher risks including infection, bleeding, and potential damage to surrounding tissue. It can also entail a hospital stay of several days and a longer recovery time, requiring the patient to use crutches or not put weight on the bone for several weeks.

Thankfully, Radiofrequency (RF) Ablation is a minimally invasive method of treatment chosen for most cases of osteoid osteoma. In this procedure, radiologists first use CT scans to identify the location of the tumor. A needle is then inserted into the tumor to deliver a high-frequency electrical current to heat and destroy the tumor.

RF Ablation is much lower risk than surgical treatment. Depending on the patient, either a regional pain block with sedation or general anesthesia is used. This procedure typically takes only 2 to 3 hours, with a recovery period of 2 to 4 hours before the patient is sent home. RF Ablation is also a curative treatment–patients usually resume normal activities within the first week after the procedure with little to no pain.

RF Ablation is the preferred method of treatment for osteoid osteoma. Our highly specialized radiologists at UVA offer RF Ablation to patients dealing with these painful bone tumors. If you or your child is experiencing symptoms of osteoid osteoma, talk to your primary care doctor or call 434.243.0321 to schedule a consultation and determine if RF Ablation is right for you.

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