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Evolution of the imaging features of osteoid osteoma treated with RFA or MRgFUS during a long-term follow-up: a pictorial review with clinical correlations


Interventional radiology is today considered the first-line treatment for osteoid osteoma both in the form of needle-guided technique of ablation (Radiofrequency) and of needleless technique (magnetic resonance-guided focused ultrasound surgery). The follow-up study of the procedures is mainly clinical, since the disappearance of pain is consistent with the success of the procedure. However, due to the minimally invasive and innovative nature of the approach, interpretation of the follow-up imaging could be ambiguous and misleading. Aim of our review was to define the main findings on the imaging that can best describe the regular evolution of these types of treatment. In particular, four findings were considered: (1) bone marrow oedema; (2) reactive phenomena (perilesional inflammatory reaction for extra-articular lesions or synovial reaction for intra-articular lesions); (3) bone remodelling (disappearance of the nidus and bone healing); (4) ring sign (considered as the granulation tissue around the nidus treated). These findings were evaluated using MRI and CT with a follow-up study that lasted up to 24 months.

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Authors wish to thank Angela Martella for translating the manuscript.


This work has not been supported by any funding.

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Correspondence to Francesco Arrigoni.

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All the clinical procedures described in the study were performed in accordance with the Helsinki declaration and patients signed an informed consent.

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This article is a retrospective study. It is based on results of standardized therapeutic treatments (non-experimental). All patients signed a informed consent.

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Arrigoni, F., Bruno, F., Gianneramo, C. et al. Evolution of the imaging features of osteoid osteoma treated with RFA or MRgFUS during a long-term follow-up: a pictorial review with clinical correlations. Radiol med (2020).

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  • Osteoid osteoma
  • MRgFUS
  • RFA
  • Bone ablation
  • Ablation follow-up
  • Interventional radiology