Osteoid Osteoma

What Is an Osteoid Osteoma?

An osteoid osteoma is a common, benign (non-cancerous) tumor that usually develops in the long bones of the leg – the thigh bone (femur) and shin bone (tibia). But, it can also occur in other bones, including the spine. It is a small tumor that measures less than two centimeters. 

Osteoid osteomas are most likely to develop in children and young adults, but can develop at any age. Males are also nearly three times more likely to be affected than females. 

Osteoid osteomas can be confused with other diseases such as osteomyelitis or osteoblastoma. For the most accurate diagnosis, your child’s physician will need to order specific imaging exams.

What Causes Osteoid Osteomas?

Osteoid osteomas occur when certain cells divide uncontrollably, and the tumor replaces healthy bone tissue with a small mass which causes reactive bone to form nearby, often resulting in pain. The cause of this is not known.

What Are Signs & Symptoms of an Osteoid Osteoma?

While symptoms can differ between patients, these are the most symptoms to watch for:

  • Dull or sharp pain that is not activity-related and is worse at night
  • Pain that is usually relieved by aspirin or other anti-inflammatory drugs
  • Limping
  • Muscle wasting
  • Bowing deformity
  • Scoliosis (with spinal osteoid osteoma)

How Are Osteoid Osteomas Diagnosed?

At Lurie Children’s, our physicians have a variety of diagnostic tests at their disposal to diagnose osteoid osteomas, including:

  • X-rays, which produce an image of the affected bones.
  • Computed tomography (CT) scan, which uses a combination of X-rays to produces cross-sectional images ("slices") of a particular part of the body. CT scans provide more detailed information than normal x-ray images.
  • Magnetic resonance imaging (MRI), which uses a combination of large magnets, radiofrequencies and a computer to produce detailed images of the bones. An MRI does not generate any radiation.
  • Needle biopsy, is a procedure where a doctor places a small needle through the skin and into the lesion to withdraw a small sample of the abnormal tissue. The tissue is analyzed by a pathologist to confirm a finding.
  • Blood tests, which are used to rule out infections.

Right – axial (“salami slice”) CT of the spine showing the small osteoid osteoma (arrow), close to the left L3 nerve root.  Left – axial (“salami slice”) MRI of the same level showing swelling (arrowheads) adjacent to the osteoid osteoma (arrow).

How Are Osteoid Osteomas Treated?

There are several treatment options available for osteoid osteomas involving bones and soft tissues. Some children may need a combination of therapies.  These treatment options include:

  • Medical treatment – Some osteoid osteomas may resolve on their own, but this may take several years. If your child is experiencing pain, non-steroidal, anti-inflammatory medications may be used.
  • Surgical treatment – If your child’s pain cannot be successfully treated with medications, a procedure may be needed. Possible surgical treatments include: 
    • CT-guided Cryoablation – This is an anesthesia-based procedure performed in the Interventional Radiology suite at Lurie Children’s. The doctors use CT-guided imaging to pinpoint the center of the tumor and insert a small needle into the tumor to freeze and kill it. These procedures take approximately 90 minutes to complete. As these procedures are minimally invasive, the incisions are closed with a bandage and pain relief typically occurs within 24 hours.
    • Intralesional Curettage – This is an anesthesia-based, open surgical procedure which involves scraping the tumor off the bone. This was a commonly-performed procedure in the past; however, as ablation has become the gold standard, this is reserved for select complicated cases. If the osteoid osteoma affects the spine, your child may need additional treatment to reinforce the spine. Our physicians will work with specialists from other departments to ensure the best possible outcome for your child.

Right – CT image during treatment.  A needle (arrow) has been placed into the epidural space, with injection of contrast (arrowheads).  This is for protection of the nerve root during treatment (neuroprotective measures). Right – the radiofrequency probe has been placed into the osteoid osteoma (arrow) for treatment.

Treatment at Lurie Children's 

Osteoid Osteomas are treated by our Interventional Radiology and Neurointerventional Radiology teams which are made up of doctors, advanced practice providers, nurses and technologists, all sub-specialized in pediatric interventional radiology. Learn more about our Interventional Radiology and Neurointerventional Radiology Programs. 

What Are the Long-Term Effects of Osteoid Osteomas?

While recurrence of osteoid osteoma is rare, an ablation can be repeated if it does occur. 

Make an Appointment

To make an appointment with one of our Neurointerventional Radiology specialists, call 312.227.5110 or email IR@luriechildrens.org.

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