Osteoid osteoma is a benign but painful bone tumor, commonly affecting young adults and adolescents. Traditional treatment involved open surgery, which required large incisions and long recovery times. However, radiofrequency ablation (RFA) has become the preferred method due to its minimally invasive approach. Radio frequency ablation uses heat generated by radio waves to destroy the tumor’s core (nidus). During the procedure, a thin needle is inserted into the tumor under CT guidance, and radiofrequency energy is applied, effectively killing the tumor cells. The process takes about 1–2 hours and offers quick pain relief, with most patients resuming normal activities within a few days. Radio frequency ablation is highly effective, with a success rate of over 90%, and carries fewer risks and complications compared to traditional surgery. It is an outpatient procedure with minimal scarring. Patients typically experience significant pain reduction within 24 hours, and long-term recurrence rates are low. Overall, radio frequency ablation is a safe and effective treatment for osteoid osteoma, offering a fast recovery and improved quality of life for patients.
Osteoid osteoma is a non-cancerous tumour. It usually develops in the long bones of the body, such as the femur (thigh) or tibia (shin). However, they can also form on the arms, fingers, feet or the spine. They cause pain and discomfort. It feels like a dull, aching pain that gets worse at night, and isn’t related to activity. Osteoid osteoma are non-cancerous and don’t spread to other parts of the body. They are also usually fairly small, with most osteoid osteoma being smaller than 1.5cm in diameter. These tumours occur in people of all ages and genders, but tend to be more common in children. People between the ages of 5 and 25 are most susceptible to developing osteoid osteoma. Men face a higher risk of having these tumours than women. Osteoid osteoma are fairly common, making up about 10% of all non-cancerous bone tumours.
The osteoid osteoma occurs when certain cells in the bone start to divide uncontrollably. They form a small, abnormal mass of tissue where healthy bone tissue should be. The reason for the abnormal cell division is still unknown. The tumour usually develops in the outer cortex of the bone. At the centre of the tumour is the “core” or nidus. This consists of rapidly multiplying tumour cells, as well as blood vessels and cells that mature into bone cells. The nidus of the tumour is encased in a hard shell made of bone. While we don’t understand the exact cause, there appears to be a link between inflammation in the bone and the development of osteoid osteoma. The inflammation appears to trigger the blood vessels in the area to expand. The bone-producing cells called osteoblasts then start reproducing rapidly. The tumour starts to push the surrounding bone tissue, when then grows over it and hardens to form the outer shell around the tumour.
The most common symptom of osteoid osteoma is pain, that isn’t caused by an injury or mechanical strain. The pain usually gets worse at night, and ruins the patient’s rest. In children, this pain is often mistaken for growing pains, so patients don’t seek help until they’ve had symptoms for months, or sometimes even years. Depending on which bone is affected, the osteoid osteoma may also cause other symptoms like scoliosis (curving of the spine), sciatica (spinal nerve pain), deformities on the hands or feet, joint pain, swelling, stiffness or difficulty moving. The orthopedic surgeon will take account of your symptoms and also conduct a physical exam during the diagnosis.
Imaging tests are also key to the diagnostic process. They help the orthopedic surgeon look for abnormal bone structures that could be causing the pain. X-rays are usually performed to check for osteoid osteoma. The tumour usually appears on X-rays as a thickened bone with an oval spot (nidus) in it. A CT scan may also be required to confirm the type of tumour. An MRI is also usually recommended to rule out any cancerous tumours. They doctor may also perform a biopsy for this reason.
In the past, osteoid osteoma were treated in one of two ways:
Both these approaches have their challenges. Minimally-invasive techniques using interventional radiology have become increasingly popular because of their ability to overcome these challenges.
Radio frequency ablation, or radio frequency neurotomy, is a minimally-invasive procedure that that uses radio waves to create heart currents and destroy the tumour cells. This process is done under real-time image guidance. Unlike open surgery, radio frequency ablation causes minimal damage to the surrounding healthy bone and soft tissue. Most patients who have undergone the procedure report complete pain relief. Radio frequency ablation is also effective at treating patients whose pain hasn’t gone away after an open tumour removal surgery.
Although radio frequency ablation is usually performed under sedation and local anaesthesia, in the case of osteoid osteoma, patients usually require general anaesthesia. This is because the tumour is painful and its location on the bone. To perform the procedure, the doctor first placed a hollow needle above the tumour and checks alignments on the real-time CT scan. Then, a bone drill is inserted through the hollow needle. A hole is drilled through the hard outer shell of the tumour. After withdrawing the drill, a biopsy needle is inserted to draw a sample of the tumour. This will be tested again by a pathologist to verify the type of tumour cells. Then, the radio frequency probe is inserted into the hole drilled in the exterior shell of the tumour, into the central core or nidus. The probe is heated and then placed in contact with the core of the tumour. Using the real-time CT scan, the surgeon moves the radio frequency probe around to ensure the entire tumour has been treated. After treatment, the probe is removed, and a self-adhesive dressing is applied to the incision site. The entire procedure usually takes about 1 to 2 hours.
Patients who undergo radio frequency ablation to treat their osteoid osteoma can expect a gradual reduction in pain after 72 hours. The pain fades away completely about a week after the surgery. It is normal for the patient to have mild bruising and bleeding on the day of the procedure. This is usually treated immediately after the surgery, and is under control by the time the patient is discharged. Rest is recommended, but patients can start doing normal daily activities. The exception to this is when large tumours are removed from the long bones of the legs. Patients are advised to avoid showering or swimming for a few days. It is recommended to avoid rigorous exercise for about 3 months after the procedure. Follow up appointments after the procedure are important to track recovery. About 10% to 20% of patients experience a recurrence of the osteoid osteoma. A second round of radio frequency ablation may be required to treat this.
Radio frequency ablation is a safe and effective treatment for osteoid osteoma. It has several advantages over conventional surgical removal such as:
Radio frequency ablation is generally safe and well-tolerated by most patients. However, as with an medical procedure, there are certain potential risks involved:
However, these risks are notably lower compared to the risks associated with open surgery.
The long-term prognosis for osteoid osteoma patients who have undergone radio frequency ablation is excellent. Most patients experience complete pain relief. They can return to their normal routines without pain or any other symptoms of the tumour. Recurrence of the osteoid osteoma after ablation is very low. However, even if it does recur, the procedure can be repeated to completely eliminate the tumour.
If you or your loved one is experiencing persistent bone pain or has been diagnosed with osteoid osteoma, advanced treatments like radiofrequency ablation can provide lasting relief. At Kauvery Hospital, our expert specialists deliver safe, minimally invasive care to restore mobility and comfort. With branches in Chennai, Hosur, Salem, Tirunelveli, and Trichy, world-class treatment is always close to you.
Osteoid osteoma is a small, non-cancerous bone tumor that causes persistent pain, often worsening at night.
It is most common in children, teens, and young adults between ages 5–25, with men being more commonly affected.
Doctors use imaging tests like X-rays, CT scans, and MRI scans to detect the tumor and confirm the diagnosis.
RFA is a minimally invasive treatment that uses heat generated by radio waves to destroy the tumor’s core (nidus).
At Kauvery Hospital, our specialists provide advanced, minimally invasive treatment across Chennai, Trichy, Salem, Tirunelveli, and Hosur.
Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai (Alwarpet, Vadapalani & Radial Road), Hosur, Salem, Tirunelveli and Bengaluru, the hospital also renders adult and paediatric trauma care.
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