What Is an Osteoid Osteoma?

It is an osteogenic benign tumor, which is more common in children and adolescents, and occurs in the long bones of the lower limbs. Its clinical feature is pain in the affected area, and aspirin can relieve pain. The pathological feature is a small, rounded bone tissue core composed of bone-like tissue and immature bone trabeculae surrounded by hardened bone. The X-ray showed that the backbone was thickened and dense. There was an X-ray translucent area with a diameter of about 1 cm, a small dense shadow in the center, and a hardened zone around it. The "nest" of the tumor core and surrounding sclerotic bone can be removed by resection.

It is an osteogenic benign tumor, which is more common in children and adolescents, and occurs in the long bones of the lower limbs. Its clinical feature is pain in the affected area, and aspirin can relieve pain. The pathological feature is a small, rounded bone tissue core composed of bone-like tissue and immature bone trabeculae surrounded by hardened bone. The X-ray showed that the backbone was thickened and dense. There was an X-ray translucent area with a diameter of about 1 cm, a small dense shadow in the center, and a hardened zone around it. The "nest" of the tumor core and surrounding sclerotic bone can be removed by resection.

Chinese name

Osteoid osteoma

Foreign name

osteoid osteoma

Etiology and common diseases of osteoid osteoma

Osteoid osteoma is a special type of benign bone tumor with unknown etiology and slow growth. It typically occurs in children and adolescents aged 5 to 20, with a male to female incidence ratio of approximately 2: 1. The most common sites are the long bones of the lower extremities, followed by the upper extremity bones, and the spine, hands, and feet are less common. Most of the lesions are single and can also affect multiple bones throughout the body. The lesions can occur in any part of the bone. About 90% of patients with osteoid osteoma are typically characterized by pain, from mild to severe, from intermittent to persistent From the local development of the lesion to radiation pain; the nature of the pain is mostly dull pain, which is characterized by nocturnal pain or aggravation of nocturnal pain.

Differential diagnosis of osteoid osteoma

Osteoid osteoma is mainly distinguished from osteoblastoma and cortical abscess. The main point of differentiation from osteoblastoma is the size of the tumor nest. If the diameter is greater than 2cm, osteoblastoma is considered, and the diameter of the tumor nest of osteoid osteoma is usually less than 2cm. Cortical abscesses often have inflammatory symptoms such as redness, swelling, heat, and pain, and a history of repeated attacks. There is no regular pain in osteoid osteoma, no calcification or ossification in the bone destruction area, and the edges are less regular than osteoid osteoma.

Osteoid osteoma examination

X-ray plain film, CT, and MRI findings were observed from the following aspects: (1) the location, size, and presence of calcification or ossification of the tumor nest; (2) osteosclerosis and periosteal reaction around the tumor nest; ( 3) Edema or articular fluid in the soft tissue and bone marrow around the tumor nest.

X-ray findings : The imaging findings of osteoid osteoma are more characteristic, and the determination of the tumor nest is the key to the diagnosis of osteoid osteoma. Tumor nests are usually located in the center of the lesion, often a single tumor nest, and occasionally more than two tumor nests. Calcification or ossification occurred in more than half of the nests, forming a "bull's eye sign". When the sclerosis around the tumor nest is extensive, the tumor nest can be hidden. At this time, tomography or CT scan can be used to show the tumor nest.

CT manifestations : Thin-layer CT scan is the best method to show osteoid osteoma tumor nests nowadays. It can show tumor nests more accurately than plain radiographs and MRI. It can diagnose suspicious cases that cannot be diagnosed by plain film, especially suitable for complex anatomical parts such as joint capsule and spine.

MRI manifestations : MRI can sensitively detect the presence of lesions. Although it can be observed from multiple directions, the determination of tumor nests is still not as good as CT.

Osteoid Osteoma Treatment Principles

The key to the surgical treatment of osteoid osteoma is to completely destroy the tumor nest, and the surrounding osteosclerotic area can be retained without causing tumor recurrence. Open tumor nest resection has a larger range of injuries and osteectomy. A small number of patients may still relapse due to incomplete tumor resection. With the development of minimally invasive surgery, in recent years, the use of CT positioning to guide percutaneous tumor destruction, laser cryotherapy or thermal coagulation has been achieved, and has achieved good results. These surgical methods are safe and easy to operate, with minimal trauma, rapid postoperative recovery, and can guarantee complete destruction of the tumor nest.