Madisons Foundation - Moms And Dads In Search Of Needed Support

What

Osteoid osteoma is a small, painful, benign overgrowth of bone. Only one lesion, less than 1.5cm in diameter, is usually present in each patient. Lesions do not grow larger over time. Osteoid osteoma never becomes malignant or cancerous.

Who

Osteoid osteoma is rare. The exact incidence is not known. Osteoid osteoma is uncommon in African Americans. Boys are affected twice as often as girls. Ninety percent of osteoid osteomas occur in individuals between the ages 5 and 25 years, and is uncommon in children younger than 5 years.

Signs and Symptoms

Seventy percent of osteoid osteomas occur in the long bones of the arms and legs with the spine being affected in 15% of children. Osteoid osteomas can be very painful. The pain usually worsens at night which can awaken the child from sleep and after exercise. The site may be tender to touch. Back pain can be so severe as to cause muscle spasm, resulting in abnormal alignment of the spine in a young child. Curvature of the spine can develop causing scoliosis. In fact, osteoid osteoma is the most common cause of painful scoliosis. The degree of spine rotation can be worse in younger children who suffer from long-lasting symptoms. Rarely, pain in the arm or leg can be so severe as to cause immobility and weakness. If osteoid osteoma occurs near a joint, swelling of the joint may occur, mimicking arthritis. The fingers of the hands and feet are occasionally involved. Skull and facial bones are rarely involved. The child with osteoid osteoma is otherwise well. Fever, weight loss, loss of appetite and fatigue are absent.

Possible Causes

The cause of osteoid osteoma is not known. It is not contagious, hereditary or preventable. It is not caused by trauma

Diagnosis

Often, osteoid osteoma may take months to years to diagnose. X-ray will often show the bone abnormality. Sometimes osteoid osteoma may not be seen on x-ray, especially when it is located in the spine, hip, hands, or feet. A CT (computed tomography) is the ultimate tool to diagnose osteoid osteoma and locate the core of the growth. It may be difficult to distinguish osteoid osteoma from malignant osteoblastoma, a cancer of the bone, and another bone abnormality called Brodie abscess (collection of pus). A bone scan is very effective for picking up osteoid osteoma. However, it too cannot distinguish osteoid osteoma from other bone abnormalities. MRI (magnetic resonance imaging) may be useful in some cases of osteoid osteoma, but is usually less helpful than CT.

Treatment

Aspirin and ibuprofen are very effective medications for relieving osteoid osteoma pain. If pain is severe, interfering with everyday activities or causing scoliosis, removal of the osteoid osteoma is recommended. Under CT guidance, a needle can be inserted through the skin to destroy the core of the osteoid osteoma using radiation, heat, or laser. This procedure is called percutaneous ablation and is successful in 95% of children. A bone scan can be used to confirm the complete removal of the osteoid osteoma.

Prognosis

The shorter the duration of symptoms, the greater the likelihood of complete removal of the growth. Similarly, any deformity caused by the pain such as scoliosis is likely to correct if symptoms have been brief. In most children, scoliosis resolves if the tumor is removed within 15 months of the onset of symptoms. Occasionally, osteoid osteoma may regress spontaneously.

Connect with other parents

In the spirit of community and support, Madisons Foundation offers the unique service of connecting parents of children with rare diseases. If you would like to be connected to other parents of children with this disease, please fill out this brief form.

Weblinks

Bone Tumors.org
ore technically oriented website but useful information for the general public can be obtained.

Diseases Database
Useful starting point for other websites and good definition of the condition.

WrongDiagnosis.com
Useful information for the general public.

Google Search for Osteoid Osteoma

References and Sources

www.emedicine.com/radio/topic498.htm by Dr. Ali Khan. www.massgeneralimaging.org/Osteoid_Osteoma_Site/Osteoid_Index.html Zileli, M et al. (2003). Osteoid osteomas and osteoblastomas of the spine. Neurosurg Focus. 15(5); E5. Knoeller, SM et al (2004) Differential diagnosis of benign tumors and tumor-like lesions in the spine. Own cases and review of the literature. Neoplasma. 51(2); 117-26.