Use of Ultrasonographic Guidance for Needle Localization of Osteoid Osteoma of the Capitate

Osteoid osteomas are benign small (typically less than 1.5 cm) osteoid-forming tumors accounting for 10–12% of all primary bone tumors. The most common sites are in the appendicular skeleton, but osteoid osteomas can occur in any bone. Classically, these tumors appear as a small sclerotic lesion with a circular lucent defect, the nidus. The nidus represents “osteoid and interconnected bone superimposed on highly vascularized connective tissue” [1, 2]. Treatment most commonly consists of medical management with nonsteroidal anti-inflammatory drugs (NSAIDs), surgical excision, and/or radiofrequency ablation. Fast scanning now made possible with multidetector computed tomography (CT) has resulted in CT-guided drilling (curettage or burr) and CT-guided percutaneous resection. More recently, there has been increased use of radiofrequency ablation of osteoid osteoma utilizing percutaneous guidance with CT [3–6]. This paper illustrates a case of an osteoid osteoma of the wrist, which was treated with surgical excision and radiofrequency ablation after needle localization under ultrasound guidance.