Abstract
IntroductionWe present a case report highlighting the unusual location and atypical imaging characteristics of an osteoid osteoma in the juxta-articular region of the femoral head, and treatment of the condition with radiofrequency ablation. This treatment option is low in both risk and morbidity and is therefore the best option in lesions that are difficult to access surgically because of the risks involved.Case presentationA 40-year-old Indian man from West Bengal presented to our facility with a history of progressively severe left hip pain of insidious onset, requiring analgesics. Imaging with plain radiographs, computed tomography and magnetic resonance imaging confirmed findings of osteoid osteoma in a subarticular location in the femoral head, although imaging features were atypical due to the intra-articular subchondral location.ConclusionRadiofrequency ablation is a newer treatment modality for osteoid osteoma that, being minimally invasive, offers comparable results to surgery with a significantly lower morbidity. To the best of our knowledge, treatment of osteoid osteoma in the foveal region of the femoral head with radiofrequency ablation has not been reported to date. We wish to highlight the successful outcome in our index case using this technique.
Highlights
We present a case report highlighting the unusual location and atypical imaging characteristics of an osteoid osteoma in the juxta-articular region of the femoral head, and treatment of the condition with radiofrequency ablation
To the best of our knowledge, treatment of osteoid osteoma in the foveal region of the femoral head with radiofrequency ablation has not been reported to date
Plain radiographs of the pelvis revealed a 15 × 11 mm, well defined lytic lesion with a thin sclerotic rim located in the subarticular portion of the left femoral head
Summary
RFA is an excellent alternative to surgical excision in the foveal region as it avoids the complications associated with surgical exposure of the femoral head, including injury to the capsular vessels and post-operative capsular laxity. It avoids weakening of the femoral neck by large diameter drilling for surgical access and chondral or osteochondral damage from resection of the subchondral lesion. In this location there exists a potential risk of avascular necrosis owing to close proximity of the foveal artery in the ligamentum teres.
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