Diagnoses A-Z

Osteoid Osteoma Symptoms, Causes & Treatment Options

Learn about Osteoid Osteoma, including symptoms, causes, treatment options, and when to seek consultation. Or take a quiz to get a second opinion on your Osteoid Osteoma from our A.I. health assistant.

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What Is Osteoid Osteoma?

Summary

Osteoid osteoma is a noncancerous bone tumor. It is most commonly found in the femur (thighbone) close to where it inserts into the hip bone. These tumors are also found in the tibia (shinbone) and the spine. Osteoid osteoma is not considered a cancerous tumor as it is very unlikely to spread throughout the body [1].

Symptoms include a dull, aching pain in your bones, localized swelling and tenderness, a discrepancy in the length of certain limbs, and possible scoliosis.

With careful monitoring, some tumors resolve on their own and can be managed with over-the-counter pain medication [2]. A few different surgical measures can also be taken in other cases, and the rate of recurrence is quite low if the tumor is completely removed.

Recommended care

You should visit your primary care physician. This condition requires a variety of treatments such as minimally invasive surgery to kill or scrape off the tumor.

How common is Osteoid Osteoma?

Rare

Never-symptoms

Symptoms that never occur with Osteoid Osteoma:

  • Hip pain
  • Bilateral leg swelling
  • Weakness in both arms
  • Weakness of both legs

Osteoid Osteoma Symptoms

The main symptom of osteoid osteoma is the associated bone pain. Other symptoms may also be present.

Main symptoms

Pain in the affected bone or bones can be described as [3]:

  • Dull, aching pain
  • Sharp and stabbing: Although, this is rarely the case.
  • Worse at night
  • Worsening as time goes on
  • Unrelated to activity: If you have an osteoid osteoma in your leg, the pain will usually not get worse with running.
  • Relieved with aspirin: This is a key feature [2]. Aspirin relieves pain in the body by blocking prostaglandins, a molecule that mediates pain. Osteoid osteomas release prostaglandins into our bloodstream, so it makes sense why a medicine blocking prostaglandins, like aspirin, would relieve the pain.

Other symptoms

In addition to pain, other symptoms may occur such as:

  • Localized swelling and tenderness: These tumors can be particularly painful when someone pushes on the spot where the growth is occurring.
  • Limb length discrepancy: This can be experienced in the upper or lower limbs. If the tumor involves the growth plate, it can cause the affected limb to be shorter than the opposite side. This can lead to problems with walking if the lower limb is affected.
  • Scoliosis: This is a deformation of the spine. Osteoid osteomas affect the normal spinal architecture and bone growth. Scoliosis can lead to impaired posture and difficulty walking among other complications.

Osteoid Osteoma Causes

The exact cause for osteoid osteoma is unknown, however, they are caused by an excess of osteoblasts. A few other conditions are also associated with osteoid osteoma.

Excess osteoblasts

Osteoblasts are cells in our bodies responsible for building new bone. The excessive bone associated with osteoid osteoma is made up of osteoid bone a different type of bone that we do not normally see proliferating in excess. Osteoid osteoma also secrete prostaglandins, a chemical signaling molecule in our bodies that is often associated with producing pain.

Other conditions

Other diagnoses to consider if osteoid osteoma is suspected include [4]:

  • Osteomyelitis: This is an infection of the bone that is easily differentiated from osteoid osteoma with imaging.
  • Stress fractures: Unlike osteoid osteoma, the pain of a stress fracture usually worsens with activity.
  • Osteoblastoma: An osteoblastoma is another noncancerous, bone-forming tumor, but it is more commonly found in the spine, is generally larger than 2 centimeters, and the pain does not usually improve with aspirin [5]. These symptoms easily differentiate them from osteoid osteomas.

Who is most often affected

This tumor most commonly presents in young adults, usually those in their early 20s, but has been reported in people as young as 4 years old. Boys are affected by this condition two to three times more often than girls [1].

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Treatment Options and Prevention for Osteoid Osteoma

Some of these tumors will eventually resolve on their own. However, a few treatment options are available, including conservative methods or surgery once a diagnosis is confirmed.

Diagnosis and confirmation

Osteoid osteoma are diagnosed with:

  • X-rays: Most osteoid osteomas are diagnosed with X-rays, in which the tumor usually appears as a small area of thickened bone around a central core.
  • CT scans or MRIs: About 25 percent of osteoid osteomas are not visible on X-rays because thickened bone has obscured the picture, and thus will require these further imaging methods [6].
  • Biopsy: A biopsy is a small sample of the bone that is usually extracted with a needle [1]. These are rarely needed to confirm the diagnosis of osteoid osteoma.

At-home treatments

If the tumor is asymptomatic or only causing minor pain, a physician may recommend:

  • Monitoring: This involves imaging every four to six months.
  • Anti-inflammatories: NSAIDs such as ibuprofen or aspirin can be used to address pain.

Surgery

If you are experiencing significant pain or bone deformities, surgical management of the tumor may be recommended. After both of these procedure types, however, most people are able to resume normal activities in a few days [6,7].

  • Curettage: Curettage is essentially scooping the tumor from the bone and is the traditional approach for these tumors. This procedure is performed under general anesthesia in which the tumor is exposed. Often times, removal of the tumor will leave a hole in the bone. This hole is usually filled with a bone graft either taken from a donor or from another bone in your body.
  • Radiofrequency ablation: This is a newer approach that is performed under general or local anesthesia. With the help of image guidance to locate the tumor, the surgeon administers a high-frequency electrical current that destroys the tumor. People undergoing radiofrequency ablation usually go home the same day and typically have less follow-up than those who receive curettage.

Prognosis

If you elect to pursue conservative observation of the tumor, it may disappear on its own in a few years. If surgical treatment is used, the tumor generally does not recur unless it was not completely removed. You should continue to follow up with your physician for an osteoid osteoma as long as symptoms or evidence of the tumor on imaging persist.

When to Seek Further Consultation for Osteoid Osteoma

You should seek further consultation if you are experiencing an extended course of bone pain, especially if there has been no recent trauma or injury to that area.

If you have pain, tenderness, and swelling

If you have these symptoms of osteoid osteoma, these are unfortunately characteristic of many conditions, so your physician will need to perform imaging to make a diagnosis.

If you have a confirmed diagnosis of osteoid osteoma

You should be informed that you have a very good prognosis as this condition is not cancerous. At that point, you and your physician will make a joint decision on whether to pursue observation or surgical removal.

Questions Your Doctor May Ask to Determine Osteoid Osteoma

To diagnose this condition, your doctor would likely ask about the following symptoms and risk factors.

  • What is your body mass?
  • Do your symptoms improve after you sit and/or lie down and rest?
  • How would you explain the cause of your foot pain?
  • How long has your foot pain been going on?
  • How severe is your foot pain?

The above questions are also covered by our A.I. Health Assistant.

Osteoid Osteoma Symptom Checker

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References

  1. Osteoid Osteoma. American Academy of Orthopaedic Surgeons: OrthoInfo. OrthoInfo Link.
  2. Yokouchi M, Nagano S, Shimada H, et al. Early Complete Remission of Osteoid Osteoma with Conservative Medical Management. Pediatric Reports. 2014;6(1):5311. NCBI Link.
  3. Canella C. Osteoid Osteoma: Diagnosis and Treatment. Radiol Bras. 2015;48(4):v. NCBI Link.
  4. Haouimi A, Gaillard F. Osteoid Osteoma. Radiopaedia.org. Radiopaedia.org Link.
  5. Atesok KI, Alman BA, Schemitsch EH, Peyser A, Mankin H. Osteoid Osteoma and Osteoblastoma. Journal of the American Academy of Orthopaedic Surgeons. 2011;19(11):678-689. PubMed Link.
  6. Chai JW, Hong SH, Choi JY, et al. Radiologic Diagnosis of Osteoid Osteoma: From Simple to Challenging Findings. Radiological Society of North America. RSNA Link. Published May 4, 2010.
  7. Chai JW, Hong SH, Choi JY, et al. Radiologic Diagnosis of Osteoid Osteoma: From Simple to Challenging Findings. Radiological Society of North America. RSNA Link. Published May 4, 2010.
  8. Ikegami M, Matsumoto T, Chang SH, Kobayashi H, Shinoda Y, Tanaka S. Anterior Impingement Syndrome of the Ankle Caused by Osteoid Osteoma in the Talar Neck Treated with Arthroscopy and 3D C-Arm-Based Imaging. Case Reports in Orthopedics. 2017;2017:2171627. NCBI Link.