Computed tomography-guided radiofrequency ablation of intra-articular osteoid osteoma: a single centre’s experience

Figures & data

Table 1. Demographics, size and location of the lesion.

Patient	Sex	Age (years)	Joint affected	Lesion size (mm)	Pain prior RFA (NVS units)
1	M	15	Hip	10	9/10
2	F	14	Hip	9	8/10
3	M	5	Hip	7	9/10
4	M	14	Hip	5	8/10
5	F	26	Hip	6	9/10
6	M	21	Hip	8	9/10
7	M	19	Facet joint	5	9/10
8	M	21	Wrist	4	8/10
9	M	6	Hip	10	8/10
10	M	17	Foot (PPJ)	4	10/10
11	M	22	Hand	5	10/10
12	M	21	Ankle (Tibio-fibular)	3	9/10
13	M	34	Shoulder	5	10/10
14	F	24	Elbow	10	7/10
15	F	32	Ankle (Talo-calcaneal)	5	9/10

Figure 1. Computed tomography axial scans of a patient with symptomatic intra-articular osteoid osteoma (biopsy proven). (A) White arrow illustrates the nidus (5 mm in diameter) of an intra-articular osteoid osteoma in the tibio-fibular joint. (B) Once inside the nidus, coaxially through the OnControl trocar the bone biopsy needle is inserted for sampling. (C) Post biopsy, the radiofrequency electrode is coaxially inserted and ablation session is performed with osteoid osteoma protocol according the manufacturer’s guidelines. (D) Post-ablation scan illustrating the access through normal bone ending inside the nidus of the osteoid osteoma.

Figure 2. Computed tomography axial scans of a patient with symptomatic intra-articular osteoid osteoma in the hand (biopsy proven). (A) Radio-opaque mesh is placed over the skin for entry point selection. (B) Post biopsy, the radiofrequency electrode is coaxially inserted and ablation session is performed with osteoid osteoma protocol according the manufacturer’s guidelines.

Table 2. Literature review of osteoid osteoma ablation techniques.

Author	Ablation method	Imagingguidance	Number ofpatients	Treatment outcome	Complications
Mahnken [9]	Monopolar RF	CT	17	Primary success rate 83% Secondary success rate 100%	No complications
Mylona [10]	Seven-array expandable RF electrode	CT	23	Primary success rate 91.3% Secondary success rate 100%	No complications
Gangi [12]	Laser ablation	CT	114	Primary success rate 98.2% Secondary success rate 99.1%	1 case of mild reflex sympathetic dystrophy of the wrist that relieved completely after 2 months
Mahnken [13]	Bipolar RF	CT	12	92% success rate	No complications
Dasenbrock [14]	Plasma mediated radiofrequency ablation	CT	3	100% success rate	No complications
Kostrzewa [15]	Microwave ablation	CT	10	100% success rate	No complications
Basile [16]	Microwave ablation	CT	7	100% success rate	No complications
Napoli [17]	MR-guided HIFU	MR	6	100% success rate	No complications
Rosenthal [29]	Monopolar RF	CT	263	Primary success rate 91%	Two anaesthesia-related complications one mild vasomotor instability that spontaneously resolved 1 case of presumed cellulitis treated with oral antibiotics
Whitmore [33]	Cryoablation	ConventionalCT 22/29 Conebeam CT 7/29	29	Short-term clinical success rate 96%	6 cases of minor complication (mild dermal blistering, transient numbness, intermittent weakness and pain)
Current study	Monopolar RF	CT	15	100% success rate	No complications

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