Radiofrequency ablation of osteoid osteoma in the upper extremity.
OBJECTIVE
To examine the results of radiofrequency ablation (RFA) of osteoid osteoma in the upper extremity.


METHODS
Twenty-nine patients with a clinical and radiographic diagnosis of an upper-extremity osteoid osteoma were referred for treatment between 1990 and 2003. All had computed tomography-guided percutaneous RFA performed by the senior investigator. Records were reviewed for patient age and gender, lesion size and location, prior treatment, and pathology results. Outcomes were determined by questionnaire via mail or telephone. Complete success was defined as complete resolution of pain without further treatment. Partial success was defined as occasional pain with activities that did not require another procedure. Failure was defined as recurrence, no change in symptoms, and/or the need for another procedure.


RESULTS
Follow-up data were available for 25 patients at a minimum of 1 year. Lesion locations included 17 humerus, 5 scapula, 2 radius, 1 ulna. Results for 19 patients were rated completely successful, 4 were rated partially successful, and 2 were rated failures. Two patients whose results were not completely successful received decreased RFA temperature or duration because of the proximity of a neurovascular bundle. There were no complications. Outcomes did not correlate with any patient or tumor characteristics.


CONCLUSIONS
Radiofrequency ablation is a safe and effective treatment for most osteoid osteomas in the shoulder, arm, and forearm. Lesions that do not allow a safe distance between the electrode and a major neurovascular structure may require surgical excision. This may be of particular importance in lesions of the hand and carpus.


METHODS
Therapeutic, Level IV.
Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA 02114, USA. msoong@partners.org
Maximillian
M
Soong
Jesse
J
Jupiter
Daniel
D
Rosenthal
D000293:Adolescent; D000328:Adult; D050280:Arm Bones / Q000000981:diagnostic imaging / Q000601:surgery*; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D017115:Catheter Ablation; D005260:Female; D006801:Humans; D008297:Male; D010017:Osteoma, Osteoid / Q000000981:diagnostic imaging / Q000601:surgery*; D012540:Scapula / Q000000981:diagnostic imaging / Q000601:surgery*; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome