Osteoid Osteoma: Causes, Symptoms, and Treatment

Published Nov 16, 2020
What is osteoid osteoma?
An osteoid osteoma is a benign or noncancerous osteoblastic (bone-forming) tumor, usually less than 1.5 cm in size. These tumors typically form in the long bones of a person’s lower body. The most prevalent area it can occur in is the femur, but it sometimes develops in a person’s hand or lower spine.
What causes osteoid osteoma?
Osteoid osteoma is not cancer, does not spread nor increase in size. An osteoid osteoma develops when specific cells divide wildly, forming a tiny mass of bone and other tissue. This tumor may bring about inflammation and tenderness around the area it’s affecting. Despite confronting many osteoid osteoma cases, many doctors and researchers still have no clue about its specific cause.
Symptoms
Osteoid osteoma leads to a lot of pain for practically all patients. In many cases, the pain patients experience would peak during night time, sometimes waking them up from their sleep. But many patients also experience this pain during the day. The pain brought about is typically a dull and aching one, but can sometimes be very sharp and aggravated by certain activities.
It was mentioned earlier that these tumors might cause inflammation and tenderness around the affected area. In response to that, many patients take aspirin, NSAIDs, or other anti-inflammatory agents. The affected part may be painful or swollen, and it’s not too uncommon to see visible lumps.
Osteoid osteoma typically occurs in the second decade of life, with most patients under 25. Curiously, this condition is found more often in boys than in girls.
Other common symptoms include:
- limping
- painful scoliosis and muscle spasticity (if the tumor is found in the spine)
- growth disturbance
- muscle wasting
- bowing deformity
- nerve symptoms like sciatica (if the tumor is found in the spine)
Diagnosis

There are several tests out there to detect osteoid osteoma. Most of these require some sort of imaging to spot these tumors ably.
X-ray
X-rays are quite the typical imaging method, providing clear pictures of bone structure and are helpful in diagnosing osteoid osteoma. They show new bone formation and spot what is called a “nidus.” The nidus is a small lucent spot, no bigger than 2 cm, which is the central zone of the osteoid osteoma.
Computerized Tomography (CT) Scan
A CT-scan provides a cross-sectional image of the bone, providing even more detailed images. They’re the better-suited method to show the new bone formation and the nidus.
Biopsy
Biopsies require taking a sample of tissue from the tumor. This sample is then examined under a microscope to confirm any suspicions of osteoid osteoma. Your physician will likely apply a local anesthetic to the area before extracting a sample with a needle. If imaging is highly suggestive of an osteoid osteoma, you may not need a biopsy.
Treatment
It’s worth noting that osteoid osteoma is not cancer, does not spread, and does not increase in size. In most cases, the tumor will go away on its own after several years. So, while the tumor does cause pain and discomfort, it does not need to be removed, as it isn’t life-threatening.
Treating the pain and discomfort
Patients typically take aspirin, ibuprofen, or any OTC anti-inflammatory drug to relieve the inflammation and discomfort brought about by osteoid osteoma.
Treating with operation/removal
Most osteoid osteomas respond very positively to CT guided percutaneous radiofrequency ablation (RF ablation). This procedure is a minimally invasive one and requires a patient to be put under general anesthesia. To do this, doctors localize the nidus of the osteoid osteoma with a CT scan and use a needle to reach its center. They then burn the tumor by sending radiofrequency waves through the needle.
The procedure is low-risk and has more than a 90% success rate. Results are almost instantaneous, as patients feel pain relief within hours of the operation. Downtime is also relatively low, with patients up and about in at most two days.
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About The Author
Terrence Tan Ting is an industrial engineer by profession but a full time writer by passion. He loves to write about a wide range of topics from many different industries thanks to his undying curiosity.