Quick answer
Osteoid osteoma is a benign bone tumour occurring mainly in adolescents and young adults (10-35 years), causing intense night-time bone pain relieved by aspirin. CT-guided percutaneous radiofrequency ablation treats this tumour without surgery.
📖 Definition & epidemiology
Osteoid osteoma is a benign bone tumour occurring most often in adolescents and young adults (10-35 years). It typically presents with intense night-time bone pain, relieved by aspirin or NSAIDs. It preferentially affects the long bones of the lower limbs (femur, tibia) but can involve any bone.
Percutaneous radiofrequency treatment has become the reference treatment for osteoid osteoma, replacing surgery in almost all cases. Cochin Hospital AP-HP has performed this technique for many years, with a 95% cure rate in a single session, under general anaesthesia, as a day case.
🦴 What is osteoid osteoma?
Osteoid osteoma is a benign bone tumour occurring most often in adolescents and young adults. It typically presents with intense night-time bone pain, relieved by aspirin or NSAIDs. It preferentially affects the long bones of the lower limbs (femur, tibia), but can involve any bone.
The diagnosis is made by bone CT, which shows the characteristic nidus: a small central lesion a few millimetres wide surrounded by a halo of sclerosis. Bone scintigraphy and MRI can complete the work-up.
⚡ Percutaneous radiofrequency: the reference treatment
Percutaneous radiofrequency thermal ablation has become the reference treatment for osteoid osteoma, replacing surgery in almost all cases. It consists of destroying the nidus with heat under CT guidance, without incision, under general anaesthesia.
What are the expected benefits?
- Cure in a single session in 95% of cases
- Rapid relief of night-time pain, often within the first days
- Treatment without incision or scar
- Day case: return home the same day
- Duration < 1 hour, under general anaesthesia for comfort
- Can be repeated in the event of the rare recurrence (< 5%)
in a single session
the procedure
on day 0
How the procedure is performed
General anaesthesia: the procedure is performed under general anaesthesia for your comfort.
Real-time CT guidance allows the nidus to be located precisely.
A radiofrequency electrode is introduced percutaneously (through the skin) as far as the nidus.
The radiofrequency current heats and destroys the nidus within a few minutes (85-90°C).
The electrode is removed. A simple dressing is enough. No scar.
Waking up and monitoring in the recovery room before returning home the same day.
📋 Before the procedure: work-up
Bone CT centred on the lesion: the key examination to confirm the diagnosis and plan the procedure.
Additional MRI possible depending on the location.
Anaesthesia consultation mandatory (procedure under general anaesthesia).
Standard preoperative blood tests.
Letter from the referring physician (orthopaedic surgeon, rheumatologist, general practitioner).
✅ After the procedure
Rapid pain relief within hours to days after the procedure: this is the sign of effectiveness.
Local post-procedural pain possible for 24-48 hours, treated with simple painkillers.
Return to light activities within 48-72 hours.
Gradual return to sport within 2 to 4 weeks depending on the location.
Follow-up CT scan at 6 months to confirm disappearance of the nidus.
In the event of recurrence (rare, < 5%): a second radiofrequency session is possible.
✅ 100% covered by French national health insurance on medical prescription · No extra fees · Cochin Hospital AP-HP
🩹 What are the possible complications?
| Complication | Description | Frequency |
|---|---|---|
| Local pain after the procedure | Transient for 24-48 hours, controlled with simple painkillers | Common |
| Skin burn at the entry point | Heals spontaneously | < 2% |
| Injury to an adjacent structure (vessel, nerve) | Prevented by appropriate protection depending on the location | < 1% |
| Local recurrence | A second radiofrequency session is possible | < 5% |
📐 What are the limits of the treatment?
For certain high-risk locations (near critical structures: spinal cord, vessels, skin), special precautions are necessary (protective cementoplasty, hydrodissection). In these cases, surgery may be offered as an alternative. Recurrence is rare (< 5%), and a second session remains possible. Surgery remains possible if necessary.
🔀 What other techniques and alternatives are possible?
🏥 Surgery
Surgical resection of the nidus, more invasive, with a scar: reserved for inaccessible cases or failures of radiofrequency ablation.
💊 NSAIDs (medical treatment)
Aspirin and NSAIDs relieve the pain but do not cure the lesion. Osteoid osteoma may regress spontaneously over several years.
❔ What happens if I finally decline the treatment?
You remain entirely free in your decision. Osteoid osteoma may regress spontaneously over several years on NSAIDs, but the pain can remain disabling in the meantime. Your physician will discuss the alternatives with you: medical treatment, monitoring, or surgery.
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❓ Frequently asked questions
How is osteoid osteoma diagnosed?
Can osteoid osteoma recur after radiofrequency ablation?
Is a referral letter necessary?
📚 Scientific references
Cardiovasc Intervent Radiol 2022.
Kedra A, Dohan A, Biau D, Belbachir A, Dautry R, Lucas A, Aissaoui M, Feydy A, Soyer P, Barat M. Cancers 2023;15(9):2657.
🔗 Related pages
✓ Why this page is trustworthy
Written by the Interventional Radiology team at Cochin Hospital AP-HP, Université Paris Cité. Medically reviewed by an interventional radiologist of the department. Last updated: July 2026.