Imran Ilyas1, Derek A Younge. 1. Department of Orthopedics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
Abstract
OBJECTIVE: To see if the results of managing osteoid osteoma with medical treatment alone is comparable to those after surgery or other ablative therapy. DESIGN: A case series. SETTING: A tertiary care centre. PATIENTS: Eleven patients with osteoid osteoma treated over a 5-year period. The condition was diagnosed from a typical history, patient age, standard radiography, computed tomography, bone scanning, complete blood count and measurement of the erythrocyte sedimentation rate. INTERVENTIONS: Continued medical treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) for 6 months after pain ceased. Surgery was done only in those who refused or could not tolerate medical treatment. MAIN RESULTS: Medical treatment successfully controlled the pain in all patients. Two patients decided to undergo surgery because of intolerance to the NSAIDS. In 7 patients the symptoms resolved after a mean time of 2.5 years. Two patients were still taking NSAIDS 5 years from the time of diagnosis. CONCLUSIONS: The natural history of osteoid osteoma is self-limited so patients should be offered nonoperative treatment, reserving ablative treatment for those who are unable or unwilling to take NSAIDs until their symptoms resolve.
OBJECTIVE: To see if the results of managing osteoid osteoma with medical treatment alone is comparable to those after surgery or other ablative therapy. DESIGN: A case series. SETTING: A tertiary care centre. PATIENTS: Eleven patients with osteoid osteoma treated over a 5-year period. The condition was diagnosed from a typical history, patient age, standard radiography, computed tomography, bone scanning, complete blood count and measurement of the erythrocyte sedimentation rate. INTERVENTIONS: Continued medical treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) for 6 months after pain ceased. Surgery was done only in those who refused or could not tolerate medical treatment. MAIN RESULTS: Medical treatment successfully controlled the pain in all patients. Two patients decided to undergo surgery because of intolerance to the NSAIDS. In 7 patients the symptoms resolved after a mean time of 2.5 years. Two patients were still taking NSAIDS 5 years from the time of diagnosis. CONCLUSIONS: The natural history of osteoid osteoma is self-limited so patients should be offered nonoperative treatment, reserving ablative treatment for those who are unable or unwilling to take NSAIDs until their symptoms resolve.
Authors: M Etchebehere; E C S C Etchebehere; L A Reganin; E M I Amstalden; A Cliquet; E E Camargo Journal: Int Orthop Date: 2004-11-06 Impact factor: 3.075