Treatment of osteoid osteoma by CT-guided drilling and ethanol instillation

History and clinical findings: For 6 months a 25-year-old man had been suffering from intermittent pain in the left upper leg, alleviated by aspirin. Physical examination was unremarkable: local pain was not elicited. Investigations: Routine radiology and computed tomography confirmed the clinically suspected diagnosis of intracortical osteoid osteoma of the femur. Skeletal scintigraphy showed distinctive local concentration of the contrast material. Diagnostic procedure, treatment and course: The lesion's central area was identified by CT and under general anaesthesia drilled into (5 mm diameter drill bit). As the lesion's edges remained partially intact, the cavity was sterilized with 1-2 ml of 96% ethanol. The patient was mobilized after six hours. He has remained free of pain in the subsequent 7 months. Conclusions: Minimally invasive, CT-guided percutaneous treatment of an osteoid osteoma can be achieved by a combined radiological and percutaneous orthopaedic procedure as an alternative to open surgery.