A 16-year-old boy presents with night pain in the mid-shaft of the tibia dramatically relieved by aspirin. CT shows a 1 cm radiolucent nidus with central calcification surrounded by dense reactive sclerosis. What is the treatment of choice if medical management fails?

• A Wide surgical excision
• B Chemotherapy
• C Amputation
• D Radiofrequency ablation ✓

Explanation

Osteoid osteoma with a nidus under 2 cm producing prostaglandin E2 causes aspirin-responsive pain. When NSAIDs fail or are not tolerated, CT-guided radiofrequency ablation is the treatment of choice, destroying the nidus with thermal energy. It is minimally invasive with high success rates. Wide excision is reserved for cases unsuitable for ablation. Chemotherapy and amputation are not indicated.

Reference: Campbell's Operative Orthopaedics, 14th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.