Treatment And Diagnosis Of Intra-articular Osteoid Osteoma

Objective:To reduce the misdiagnosis and mistreatment rate of osteoid osteoma by exploring the diagnosis and treatment of intra-articular osteoid osteoma.Methods:From January 2013 to July 2013,12 cases with intra-articular osteoid osteoma confirmed by pathology in our hospital,were retrospectively analyzed.VAS score combined with clinical manifestations,were used to evaluate the clinical efficacy.X-ray,CT and MRI were used for imaging evaluation.Four cases were treated by open surgery and 8 cases treated by CT-guided percutaneous radiofrequency ablation.Routine pathologic examination was performed after operation.Results:There were 8 males and 4 females with the average age of 23 years old(from 9 to 55).Tumor nests range from 0.5 cm to 1.2 cm in diameter with an average of 0.8 cm.Diagnosis time was from 2 months to 28 months,with an average of 12 months.The average VAS scores before operation,postoperative 72 hours and postoperative 4 months were respectively 4.5 points,1 points and 0.5 points.The p value was lower than 0.05.Thin layer CT can totally display the tumor nests,among which the typical "bull's-eye" in 10 cases(83%).42%cases can be displayed on X-ray and 90%displayed on MRI.The effect of operation is good,with no recurrence and complication.Conclusions:Thin layer CT is best diagnosis imaging methods for intra-articular osteoid osteoma.Intra-articular osteoid osteoma can be more accurately diagnosed via thin layer CT combined with clinical manifestations to reduce the misdiagnosis and mistreatment rate.CT-guided percutaneous radiofrequency ablation is a minimally invasive percutaneous rotary cutting method for intra-articular osteoid osteoma,which is simple,safe and effective.