Osteoid osteoma is a small, benign bone tumor that can occur in any part of the skeletal system and causes persistent pain that worsens with activity. It is commonly diagnosed with radiographic imaging and treated with complete excision or autologous bone grafting.
An osteoid osteoma is a benign, often solitary bone tumor or lesion typically no more than 1.5 cm in diameter. It is usually composed of osteoid bone and tissue, which are immature forms of bone. The cause is unknown and can arise in almost any part of the skeletal system, including the long bones of the legs, such as the femur and tibia. The bones of the hands, feet, and spine are also common sites for osteoid osteoma.
The cancer is commonly seen in Caucasians between the ages of 5 and 56 and affects men more than women. It is less likely to occur in children younger than 5 years of age. The primary complaint in osteoid osteoma is persistent mild pain that worsens with activity over several months. The intensity of the pain increases until it becomes severe enough to disturb the patient’s sleep. Pain is often relieved by taking pain medication in small doses.
Other symptoms include stiffness and weakness in adjacent muscles of the affected bone. A lameness also occurs when the lesion develops in the legs. Localized swelling may be present, but there is usually no increase in body temperature. Osteoid osteoma of the spine, an osteoid osteoma that grows in the vertebrae of the spine, usually leads to scoliosis, an abnormal curvature of the spine, and torticollis, also known as a twisted neck or torticollis.
Osteoid osteoma is usually diagnosed with various radiographic imaging techniques, often depending on the site of the affected area. Computed tomography (CT) and magnetic resonance imaging (MRI) are often used to assess the precise location of the tumor. CT, however, has the added benefit of also being used in osteoid osteoma ablation, a surgical procedure for removing the tumor. Single proton emission computed tomography (SPECT) is the method usually requested when the cancer affects the part of the vertebra called the spinous process. Angiography, an imaging technique usually done to evaluate blood vessels, and Doppler ultrasonography are sometimes used in tumor detection.
The best treatment for osteoid osteoma is complete excision or removal of the lesion. This often results in immediate and permanent pain relief. Autologous bone grafting is also sometimes used for treatment. It is a procedure in which replacement bone is obtained from other parts of the patient’s body to fill in the area where the bad bone was removed. The lesion eventually subsides if it is not removed, however, the pain may persist for a number of years.
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