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TREATMENT WITH CT GUIDED RADIOFREQUENCY THERMAL ABLATION FOR OSTEOID OSTEOMA OF THE FOOT AND ANKLE. A REPORT OF 6 CASES



Abstract

Purpose: To report our experience in diagnosis and treatment of Osteoid Osteoma in the foot and ankle.

Material and Methods: Six patients, 4 males and 2 females, mean age 24 (range 17–40), were diagnosed, suffering of osteoid osteoma of the foot and ankle in our outpatients clinic. All the patients had typical spontaneous pain and night pain improved by NSAIDs. In all patients, the diagnosis was delayed for one – two years. Treatment by Computed Tomography guided percutaneous radiofrequency ablation was performed in 4 patients, one patient underwent CT guided curettage and one underwent open excision and local bone graft of the lesion. In patients treated by RF, the lesions were heated three times to 90° for 2 minutes. All the procedures were done under ankle block and local anesthesia. Patients were evaluated in our outpatients foot and ankle clinic 1–2 years following the procedure.

Results: The Osteoid Osteoma was found in the talus of two patients and one in the cuboid, one in the base of third metatarsus, one in the calcaneus and one in the ankle. In all patients most of the pain was resolved within 3 days of the procedure. In 3 patients after a year there was still mild pain at tremendous physical efforts attributed to minimal damage to adjacent joint. Three patients completely recovered including pain free physical efforts. CT at follow-up in 2 patients revealed no pathology of the involved bones.

Conclusions: OO is an uncommon affection in the foot and ankle. The diagnosis is difficult and usually there is delayed. CT guided percutaneous radiofrequency of the foot is a safe and effective. The procedure can be performed under ankle block and local anesthesia.

Correspondence should be addressed to: Orah Naor, IOA Secretary and Co-ordinator (email: ioanaor@netvision.net.il)