This article reviews current trends in the treatment of osteoid osteoma, with an emphasis on the evolving use of radiofrequency thermoablation as a primary definitive treatment and for recurrent and residual lesions. In so doing, the article reviews the merits and relative disadvantages of both surgical and nonsurgical imaging-guided techniques in treatment. Radiofrequency ablation of osteoid osteoma is a highly effective, efficient, minimally invasive and safe method of treating osteoid osteoma. Clinical success range from 76% to 100%. Surgery remains the standard treatment in cases where histology of the lesion is in doubt, neurovascular structures are within 1.5 cm or in repeated failure of any other minimally invasive ablative technique or percutaneous resection. Clinical success of surgery ranges from 88% to 100%. Laser interstitial thermal therapy shares many of the advantages and much of the success of radiofrequency thermoablation but has not been as available. Clinical success ranges from 87% to 100%. Cryotherapy, ethanol therapy and imaging-guided excision remain second-line therapies. Clinical success ranges from 77% to 100% for imaging-guided resection and 100% for ethanol therapy.
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Published online: August 19, 2004Eur Radiol 2004;14:607–617
© 2004 Elsevier Inc. Published by Elsevier Inc. All rights reserved.