Osteoid osteoma and osteoblastoma are commonly seen benign osteogenic bone neoplasms. Both tumors are typically seen in the second decade of life, with a notable predilection in males. Histologically, these tumors resemble each other, with characteristically increased osteoid tissue formation surrounded by vascular fibrous stroma and perilesional sclerosis. However, osteoblastomas are larger than osteoid osteomas, and they exhibit greater osteoid production and vascularity. Clinically, osteoid osteoma most commonly occurs in the long bones (eg, femur, tibia). The lesions cause night pain that is relieved with nonsteroidal anti-inflammatory drugs (NSAIDs). Osteoblastoma is most frequently located in the axial skeleton, and the pain is usually not worse at night and is less likely to be relieved with NSAIDs. Osteoblastoma can be locally aggressive; osteoid osteoma lacks growth potential. Osteoid osteoma may be managed nonsurgically with NSAIDs. When surgery is required, minimally invasive methods (eg, CT-guided excision, radiofrequency ablation) are preferred. Osteoblastoma has a higher rate of recurrence than does osteoid osteoma, and patients must be treated surgically with intralesional curettage or en bloc resection.
From the Institute of Medical Science, University of Toronto, Toronto, ON, Canada (Dr. Atesok), the Division of Orthopaedic Surgery, The Hospital for Sick Children, Toronto (Dr. Alman), the Division of Orthopaedics, Department of Surgery, St. Michael's Hospital, University of Toronto, Toronto (Dr. Schemitsch), the Department of Orthopedics, Shaare Zedek Medical Center, Jerusalem, Israel (Dr. Peyser), and the Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA (Dr. Mankin).
Dr. Atesok or an immediate family member serves as a board member, owner, officer, or committee member of the International Society of Arthroscopy, Knee Surgery, and Orthopaedic Sports Medicine and the Orthopaedic Research Society. Dr. Alman or an immediate family member serves as a board member, owner, officer, or committee member of the Pediatric Orthopaedic Society of North America. Dr. Schemitsch or an immediate family member has received royalties from Stryker; serves as a paid consultant to Amgen, Stryker, Synthes, Smith & Nephew, Baxter, Wright Medical Technology, and Kuros; has received research or institutional support from Smith & Nephew; has received nonincome support (such as equipment or services), commercially derived honoraria, or other non-research-related funding (such as paid travel) from the Canadian Institutes of Health Research, BrainLAB, OMEGA, Smith & Nephew, Zimmer, and Stryker; and serves as a board member, owner, officer, or committee member of the Orthopaedic Trauma Association, Canadian Orthopaedic Association, and Osteosynthesis and Trauma Care Foundation. Neither of the following authors nor any immediate family member has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Peyser and Dr. Mankin.