Osteoid Osteoma: Magnetic Resonance guided High Intensity Focused Ultrasound for entirely non-invasive treatment. A prospective developmental study.

Osteoid osteoma is a painful albeit benign bone lesion that usually affects younger subjects between 10 and 20 years of age. The most frequent symptom is localized bone pain that flares up nocturnally. Prompt relief is usually achieved with nonsteroidal anti-inflammatory drugs (NSAIDs). Once diagnosis has been established, conventional therapy options include surgery, pharmacological and/or percutaneous treatment. Minimally invasive therapies are increasingly the primary option at many centers. At present, radiofrequency (RF) ablation is the most popular of the various percutaneous techniques, with the percentage of patients reporting complete clinical success ranging between 85 and 98% at one year. Magnetic Resonance guided Focused Ultrasound (MRgFUS) is a non-invasive ablation modality that, due to the high acoustic energy absorption of cortical bone, may produce thermal damage to periosteal structures including nerves (i.e. periosteal neurolysis) and can potentially penetrate into the medullary bone, leading to coagulative necrosis of sub-cortical lesions. Our purpose was to investigate feasibility, safety, and clinical efficacy of MRgFUS in the treatment of painful osteoid osteoma.

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