A osteoid osteoma is a benign bone tumor arising from osteoblasts and is initially thought of as a smaller version of osteoblastoma. Osteoid osteomas tend to be less than 1.5 cm. Tumors can be present in any bone in the body but most commonly occur in long bones, such as the femur and tibia. They are responsible for 10 to 12 percent of all benign bone tumors. "Osteoma osteoma can occur at any age, and is most common in patients between the ages of 4 and 25. Men are affected about three times more often than women."
Video Osteoid osteoma
Presentations
Marked with a diameter of less than 1.5 cm, osteosis osteoma is most common in young men (Men: Women ratio 3: 1) and can occur in any body bone, most commonly around the knee but often also seen in the spine, length and less frequently in the mandibular bone or other craniofacial bone.
Severe pain usually occurs at night, but can be constant at any time of the day. The main complaint may be dull, persistent, 24-hour dull pain but significantly increased at night. Pain tends to decrease with NSAIDs such as ibuprofen.
Maps Osteoid osteoma
Histological findings
On histologic examination osteoid osteoma consists of osteoid nodes and small bone weave (& lt; 1.5Ã ¢ â,‰ € Å"2 cm), yellowish to red with interconnected trabeculae, and the background and edges of a highly vascularized fibrous connective tissue. Various degrees of sclerotic bone reaction may surround the lesion. Benign osteoblastoma is almost indistinguishable from osteoid osteoma. The usual appearance includes fibrovascular stroma with many osteoblasts, osteoid tissue, well-formed woven bones, and giant cells. Osteoblasts are generally small and regular.
Symptoms
Symptoms of Osteoma The most common osteopoids are:
- dull pain that increases to severe at night OR a little pain, increases to severe even at night, affects sleep quality
- hobbled
- muscle atrophy
- bent defect
- swelling
- increased or decreased bone growth
The most common symptom is the pain that can be lost with painkillers at the beginning. Once the benign tumor develops further, the pain can not be reduced with medication and mild to severe swelling begin to occur. Although, in some cases, the level of pain has remained the same for years, and regular NSAID intake keeps pains at bay. Tumors are often found through x-ray imaging. "Conventional radiography reveals well-disseminated lytic lesions (nidus) surrounded by different sclerosis zones" that allow physicians to identify tumors.
Diagnosis
Osteoid osteoma radiographs usually show round lucency, containing a solid sclerotic center nidus (characteristic lesion on this type of tumor), surrounded by sclerotic bones. Nidus rarely larger than 1.5 cm.
Lesions in most cases can be detected on CT scans, bone scans and angiograms. Plain photos are not always diagnostic. MRI adds little CT findings that are useful for localization. Radionuclide scanning shows intense absorption which is useful for localization during surgery using a hand-held detector, and to confirm that all lesions have been removed.
Treatment
Pain can be reduced with nonsteroidal anti-inflammatory drugs.
Treatment varies depending on the patient's health. If he is healthy and not bothered by pain, the tumor is treated symptomatically with anti-inflammation. If this therapy fails or the location of the tumor may cause growth disorders, scoliosis, or osteoarthritis, surgical or percutaneous ablation may be considered. If surgery is preferred, the individual may be referred to a podiatrist or orthopedic surgeon to perform the procedure. Postoperative therapy and strengthening may be necessary, depending on the location of the tumor and the health of the individual. Although proven to be effective, surgical resection has many potential complications, including the identification of a tumor that is difficult to operate, local recurrence of unresolved resection, and burden-resistant bone resection that may require hospitalization of the old hospital and complicate recovery.
Recently, CT scan radiofrequency ablation has emerged as a less invasive alternative to surgical resection. In this technique, which can be done in the subconscious of sedation, the RF probe is inserted into the nidus tumor through a cannulated needle under CT guidance and heat is applied locally to destroy tumor cells. Since the procedure was first introduced for the treatment of osteoid osteomas in the early 1990s, it has been proven in many studies to be less invasive and costly, to produce less bone damage and have equal safety and efficacy for surgical techniques, with 66 to 96% of patients reporting freedom of symptoms. While initial success rates with high RFA, symptomatic relapse after RFA treatment have been reported, with some studies showing recurrence rates similar to surgical treatments. On July 17, 2014, treatment with an incision operation using MRI to guide high intensity ultrasound waves to destroy benign bone tumors in the legs has been demonstrated.
References
15. Satish Karandikar, Gagan Thakur, Manisha Tijare, Shreenivas K, Kavita Agarwal. Osteoid
osteoma mandibula. BMJ Case Report. 2011; 10.1136/bcr.10.2001.4886.
External links
Source of the article : Wikipedia
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