EURORAD ESR

Case 7482

Osteoid osteoma of the femur: CT-guided percutaneous radiofrequency ablation

Author(s)
Angeli S, Neri E, Cioni R, Faggioni L, Caramella D, Bartolozzi C.
 
Patient
male, 27 year(s)
 
 
  • Figure 1
    Pretreatment US examination.

    US examination shows an 8-mm nodule-shaped irregularity of the cortex of the middle portion of the left femural diaphysis (asterisks). The cortical profile is remodelled and the periosteum is lifted outward.

     
     
     
  • Figure 2
    Pretreatment MRI.
     

    T1-weighted image shows hypointense nodule-shaped lesion located in the outer portion of the cortex.

     

    On axial STIR image the lesion is hyperintense with edema of the surrounding muscle.

     

    On sagittal STIR image the lesion is hyperintense with edema of the surrounding muscle. The signal intensity of the remaining bone included in the field of view is normal.

     

    T1-weighted image after intravenous administration of gadolinium chelate shows enhancement of the lesion and the surrounding muscle.

     

    Signal-intensity-versus-time plot shows rapid and intense contrast medium uptake of the lesion (1) followed by slow wash-out, compared with nearby cortex (2) and non-edematous muscle (3).

     
     
     
  • Figure 3
    Preprocedural CT.
     

    Preprocedural axial CT image shows focal lysis of the outer aspect of the femural cortex with calcified central core (nidus).

     

    Preprocedural reformatted sagittal CT image shows focal lysis of the outer aspect of the femural cortex with calcified nidus. The remaining cortex included in the field of view is normal.

     
     
     
  • Figure 4
    CT-guided RFA.
     

    CT-guided insertion of the RFA needle inside the lesion.

     

    CT image obtained immediately after RFA showing wedge-shaped osteolysis in the ablation site.

     
     
     
  • Figure 5
    Post-treatment US examination.

    Control US examination performed ten days after RFA shows bone scarring (asterisk) with minimal perilesional hematoma (rectangle).

     
     
     
US examination shows an 8-mm nodule-shaped irregularity of the cortex of the middle portion of the left femural diaphysis (asterisks). The cortical profile is remodelled and the periosteum is lifted outward.
 
T1-weighted image shows hypointense nodule-shaped lesion located in the outer portion of the cortex.
 
On axial STIR image the lesion is hyperintense with edema of the surrounding muscle.
 
On sagittal STIR image the lesion is hyperintense with edema of the surrounding muscle. The signal intensity of the remaining bone included in the field of view is normal.
 
T1-weighted image after intravenous administration of gadolinium chelate shows enhancement of the lesion and the surrounding muscle.
 
Signal-intensity-versus-time plot shows rapid and intense contrast medium uptake of the lesion (1) followed by slow wash-out, compared with nearby cortex (2) and non-edematous muscle (3).
 
Preprocedural axial CT image shows focal lysis of the outer aspect of the femural cortex with calcified central core (nidus).
 
Preprocedural reformatted sagittal CT image shows focal lysis of the outer aspect of the femural cortex with calcified nidus. The remaining cortex included in the field of view is normal.
 
CT-guided insertion of the RFA needle inside the lesion.
 
CT image obtained immediately after RFA showing wedge-shaped osteolysis in the ablation site.
 
Control US examination performed ten days after RFA shows bone scarring (asterisk) with minimal perilesional hematoma (rectangle).
 
 
 
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