Management of Osteoblastoma and Giant Osteoid Osteoma with Percutaneous Thermoablation Techniques.

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Abstract

Conflict of interest statement: The authors declare no conflict of interest. 2. J Bone Joint Surg Am. 2019 Mar 20;101(6):486-493. doi: 10.2106/JBJS.18.00888. Osteoid Osteoma About the Hip in Children and Adolescents. May CJ(1), Bixby SD(1), Anderson ME(1), Kim YJ(1), Yen YM(1), Millis MB(1), Heyworth BE(1). Author information: (1)Departments of Orthopedic Surgery (C.J.M., M.E.A., Y.J.K., Y.-M.Y., M.B.M., and B.E.H.) and Radiology (S.D.B.), Harvard Medical School and Boston Children's Hospital, Boston, Massachusetts. BACKGROUND: The etiology of hip pain in pediatric and adolescent patients can be unclear. Osteoid osteoma (OO) about the hip in children has only been described in case reports or small studies. The present study assessed the clinical presentation and diagnostic course, imaging, and treatment approaches in a large cohort of pediatric cases of OO about the hip. METHODS: Medical record and imaging results were reviewed for all cases of OO identified within or around the hip joint in patients 6 months occurred in 43% of patients. Three patients underwent operative procedures for other hip diagnoses, but all had persistent postoperative pain until the OO was treated. Of the 41 patients (82%) who ultimately underwent radiofrequency ablation (RFA), 38 (93%) achieved complete post-RFA symptom resolution. CONCLUSIONS: Initial misdiagnosis, the most common of which was FAI, and delayed correct diagnosis are common in pediatric OO about the hip. Presenting complaints were variable and nonspecific MRI findings were frequent. Night pain and relief with NSAIDs were present in the vast majority of cases. CT scans provided definitive diagnosis in all patients who received them. As increasing numbers of young, active patients are being evaluated for various causes of hip pain, such as FAI, OO should not be overlooked in the differential diagnosis. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. DOI: 10.2106/JBJS.18.00888