Is pain duration associated with morphologic changes of osteoid osteomas at CT?
OBJECTIVE
To assess the morphologic changes of osteoid osteomas on computed tomographic (CT) scans in association with pain duration.


METHODS
Institutional review board approval was obtained. Informed consent was waived. From January 2008 to December 2012, 235 patients were treated with interstitial laser ablation at the Hôpital Lariboisière. Ninety-six patients with histopathologically proven osteoid osteomas, complete clinical files, and CT data were studied retrospectively. The following variables were assessed: age, sex, bone location, bone segment, location of the osteoid osteoma in relation to the native cortex, nidus area, nidus calcification area and attenuation at CT, and nidus mineralization ratio (percentage of the calcification area over the total nidus area). Analysis of variance, Kaplan-Meier method, and Cox multivariate regression model were used for statistical analyses.


RESULTS
The study sample consisted of 96 patients, 68 of whom were male (71%) and 28 of whom were female (29%) (ratio of male to female patients, 2.4:1). Mean age ± standard deviation was 22.2 years ± 10.4 (range, 4-54 years; median, 18.5 years). The patients' age and nidus mineralization ratio increased significantly with pain duration (hazard ratio, 0.975 [P = .031] and 0.193 [P = .007], respectively). No significant association was found between pain duration and other variables, including the nidus area. In long bones, diaphyseal osteoid osteomas were significantly less mineralized than those in other locations (P = .009).


CONCLUSIONS
The nidus mineralization ratio of osteoid osteomas increases significantly with pain duration and may be a marker of tumor age. Diaphyseal osteoid osteomas demonstrate a lower ratio of nidus mineralization. At the onset of symptoms, older patients experience pain for a longer period before treatment.
From the Department of Osteoarticular Radiology, Hôpital Lariboisière, AP-HP, 2 rue Ambroise Paré, 75475 Paris Cedex 10, France.
Sébastien
S
Touraine
Luciano
L
Emerich
Damien
D
Bisseret
Idan
I
Genah
Caroline
C
Parlier-Cuau
Bassam
B
Hamze
David
D
Petrover
Jean-Denis
JD
Laredo
Valérie
V
Bousson
D000293:Adolescent; D000328:Adult; D001706:Biopsy; D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010017:Osteoma, Osteoid / Q000000981:diagnostic imaging* / Q000473:pathology; D010146:Pain / Q000473:pathology*; D010147:Pain Measurement; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*