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Home > Conditions & Treatments
Bone Tumor - Osteoid Osteoma
Condition What is osteoid osteoma?
Osteoid osteoma is a benign bone-forming tumor that was first described in 1935. Although most doctors rarely see patients with this condition, compared to other types of bone tumors it is relatively common. Osteoid osteoma may occur in any part of any bone, but is most frequent in the legs, especially the femur. Osteoid osteoma is usually found in children and young adults. It is rare in very young children (less than 3 years) and in adults over the age of 40. Almost all patients have pain from the tumor.
What are symptoms of osteoid osteoma?
Pain due to osteoid osteoma most often begins as a dull aching sensation, becoming sharper and more severe with time. Pain is typically (but not invariably) worse at night. Although pain may be worsened by activity, it is not due to activity and also occurs at rest. The tumor may cause a marked inflammatory reaction in surrounding tissues, resulting in the feeling of swelling or a lump. There is usually prompt pain relief with nonsteroidal anti-inflammatory agents (such as aspirin and ibuprofen), but relief may be of variable duration.
TreatmentWhat type of treatment is available for osteoid osteoma?
Radiofrequency Ablation (RFA) for osteoid osteoma is performed with CT guidance for localization of the lesion. A radiofrequency probe is inserted into or next to a tumor mass. By exerting radio-energy with frequency around 460 kHz, the tumor mass is heated to a point where abnormal cells are destroyed. Sterile technique is used. Advantages of Radiofrequency Ablation (RFA) treatment compared to surgery:
- Rapid pain relief usually apparent within 24 hours
- Patient can bear full weight on the treated extremity immediately after the procedure
- Little tissue damage - hence no structural weakening
- No overnight hospital stay
- Prompt return to work, school and other usual activities
- Minimal post-procedure care
- Lower cost
When should I consider RFA?
There are certain times when removal of the tumor is preferred.
Tumors within a joint (intraarticular) may cause an inflammation of the joint (synovitis), which may progress later to osteoarthritis.
When the tumor is near the growing end of a bone in a child, increased blood flow may cause either overgrowth or undergrowth of the limb.
Osteoid osteoma in the spine may cause a curvature of the spine in children, which may become permanent if allowed to persist for long periods of time.
Finally, some patients develop gastrointestinal problems from the use of anti-inflammatory medications. These may include heartburn, stomach ulcers and bleeding problems.
What should I expect BEFORE RFA?
An MGH musculoskeletal radiologist will need to confirm the diagnosis of osteoid osteoma by reviewing the symptoms and the imaging studies. X-rays are almost always obtained as part of the initial evaluation of a bone problem. The CT scan is especially important, and is superior to MRI for this purpose. The CT scan will also help to determine whether there is a safe needle access to the tumor, and whether there are any important anatomical structures to be concerned about.
 Review of the symptoms can be done by telephone or by a referral letter from your doctor. We should talk about the nature of the procedure so that you understand all the issues, including the availability of alternative treatments and the probability of success. This is best done after we review the images, because it will make the discussion more specific.
There will undoubtedly be some insurance issues to address. Our secretary is experienced at dealing with a variety of insurance plans. You may need a referral from your local doctor, especially if this is an issue related to coverage outside of the plan area. We can help you to identify places to stay and provide travel directions
It would also be helpful if your local doctor performs a basic pre-anesthesia history and physical examination within a few weeks of the procedure. We have simple one-page forms for this purpose that we could send you. If your local doctor would prefer it, we would be happy to speak to him or her.
What should I expect DURING RFA?
RFA for osteoid osteoma takes approximately 2 hours, followed by another 2-3 hours in a recovery area. Patients are discharged in the afternoon of the procedure. There is often some pain on the day of the procedure. However, within 24 hours most patients are able to tell that the tumor is gone. Within 2-3 days most individuals are pain-free.
What should I expect AFTER RFA?
Some patients with tumors in the legs may be advised to avoid vigorous sports activities such as long distance running or jumping for 3 months. No other activities are restricted. Two follow-up visits are performed, one after one month, and a second after one year.
You will need to have someone to follow up on the treatment locally. If your local pediatrician or orthopedic surgeon is comfortable with having you consider this alternative he/she may be willing to do that.
Our Service
The Division of Musculoskeletal Imaging & Intervention at Massachusetts General Hospital consists of eight full-time radiologists all of whom are board certified in general radiology and fellowship trained with additional specialization in image-guided non-interventional and interventional musculoskeletal procedures. In addition, each has extensive training in the use of x-ray equipment, x-ray dye, and image interpretation.
Please see below for our musculoskeletal radiologists who specialize in RFA for osteoid osteoma.
- William E. Palmer, MD
- Miriam A. Bredella, MD
- Ambrose J. Huang, MD
- Susan V. Kattapuram, MD
- Tara M. Lawrimore, MD
- Hugue A. Ouellette, MD
- Daniel I. Rosenthal, MD, FACR
- J. Shannon Swan, MD
- Martin Torriani, MD, MSc
Where is RFA for osteoid osteoma performed?
Massachusetts General Hospital
Division of Musculoskeletal Imaging & Intervention
Yawkey Center for Outpatient Care
55 Fruit Street, YCOC 6 (YCOC 6 Floor Map  )
Boston, MA 02114
How to schedule RFA for osteoid osteoma
A referral from a physician is necessary to schedule a RFA treatment for osteoid osteoma.
Phone: 617-724-PAIN (7246)
To assist with scheduling please have the following information ready when calling:
- Name and phone number of the physician ordering the RFA for osteoid osteoma
- Indication for RFA for osteoid osteoma
- Patient Medical Record Number (MRN)
Additional Information and Resources
MGH Collaborative Care
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