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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2006 April;57(2):47-56
Shoulder pain induced by cancellous epiphyseal osteoid osteoma
Boffano M., Martorano D., Regis G., Albertini U., Gallo A., Mosetto F., Sacco F., Faletti C., Brach del Prever E. M.
1 Dipartimento di Ortopedia e Traumatologia Unità Operativa Dipartimentale di Chirurgia Ortopedica Oncologica e Ricostruttiva ASO CTO, CRF, MA di Torino, Torino
2 Dipartimento di Diagnostica per Immagini Unità Operativa Autonoma di Radiologia Diagnostica ASO CTO, CRF, MA di Torino, Torino
Osteoid Osteoma (OO) is a benign neoplasm of bone, cancellous epiphyseal intra-articular type could be problematic both for diagnosis and treatment. Aim of the study was to define imaging characters of cancellous intra-articular OO and treatment. Analysis of a case of OO in the proximal humerus treated with radiofrequency thermo-ablation under CT guidance without complications. Literature researches using Pubmed, Scopus, Scirus, Guidelines Finder; keywords “osteoid osteoma, cancellous, intramedullary, epiphyseal, radiofrequency, laser, percutaneous” differently combined. Inclusion criteria: English, French, Italian language; guidelines, cohort prospective studies, retrospective studies, case control studies, reviews, case reports. Cancellous epiphyseal OO are studied in 1 prospective and 7 retrospective studies, 3 reviews, 12 case reports or case series. Treatment is evaluated in 5 reviews, 1 guideline, 19 cohort prospective studies, 4 retrospective studies, 1 case control study, 7 case reports or case series, 1 technical note, 1 new technique description. Cancellous intra-articular OO is uncommon and must be identified with MR or CT. Radiofrequency thermo-ablation under CT guidance is less invasive, with less complications and with a recovery time shorter than surgical removal. In literature there are not case reports about cancellous intra-articular OO treated with thermo-ablation. Clinical symptoms of osteoid osteoma without radiographic lesions must be studied with second level exams (CT, MR). Radiofrequency thermo-ablation under CT guidance is an effective procedure and also in the epiphyseal cancellous localization is indicated.