An osteoid osteoma is characterised by a central nidus (<2 cm) that produces prostaglandin E2 causing pain. The drug that MOST effectively relieves pain by directly targeting this mechanism is:
- A Morphine
- B Steroids (dexamethasone)
- C Aspirin/NSAIDs ✓
- D Gabapentin
Correct answer: C. Aspirin/NSAIDs
Explanation
The classic pain of osteoid osteoma is nocturnal pain that is dramatically relieved by NSAIDs (salicylates/aspirin) — a pathognomonic clinical feature. The nidus contains vascular fibrous tissue rich in prostaglandin E1 and E2, which sensitise peripheral nociceptors. NSAIDs inhibit cyclooxygenase, reducing prostaglandin synthesis and pain. This NSAID response is so characteristic that relief of nocturnal bone pain by aspirin is a clinical diagnostic criterion. Definitive treatment is percutaneous radiofrequency ablation (CT-guided), which achieves >90% cure.
Reference: Maheshwari Essential Orthopaedics, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.