CIO 2022-14 Radiofrequency Ablation in Osteoid Osteomas of Typical and Atypical Presentations

Purpose: To evaluate the technical and clinical success and complications of radiofrequency ablation (RFA) in osteoid osteomas with typical and atypical presentations.

Materials and Methods: We prospectively reviewed 380 patients (age range, infant to 40 years) in whom RFA was performed between October 2015 and December 2021 for osteoid osteomas with typical and atypical presentations. Atypical presentations included atypical sites such as the clavicle, talus, cervical vertebra, or acetabulum and in an atypical age such as infants. After preprocedural evaluation and imaging, all patients underwent RFA of osteoid osteomas under computed tomography guidance. We evaluated for technical success of the procedure, pain relief, recurrence, and all complications of the procedure. The procedure was done using RITA equipment.

Results: Technical success was achieved in all patients, with intranidal localization of the needle and complete ablation. Successful pain relief was achieved in all patients within 1 day to 1 week. Immediate complications included five cases of minor thermal skin burn of about 1 cm, which subsided on their own. Another seven patients with osteoid osteoma of the proximal shaft of left femur developed pain in the lateral aspect of the lower half of the thigh after RFA, which subsided in 2 weeks. During follow-up, eight patients developed recurrence after 6 months, which was treated with repeat RFA.

Conclusions: RFA is a relatively safe, minimally invasive, and effective method for the management of osteoid osteomas with few complications.