Osteoid osteomas are tumors with intense clinical symptoms and extensi
ve reactive bone changes far exceeding the volume of the lesion itself
. Because of their small size they can be approached by minimally inva
sive surgical procedures. We treated ten symptomatic patients with ost
eoid osteomas (n 6 hip point, n 1 iliac bone, n 1 femoral diaphysis, n
2 tibial diaphysis) by excision of the nidus with a 3-mm Harlow-Wood
needle using a percutaneous CT-guided approach. Seven patients with re
sidual tumor were treated with either thermocautery (n 2) or sclerosis
with 1 ml of 96% ethanol (n 5). Six patients had instant and constant
relief (3 years' observation) of their pain. In two patients a second
transcutaneous intervention was successful. Only two patients needed
open resection. Compared with the invasive open resection of the tumor
s, sometimes even putting the stability of the femoral neck at risk,tr
anscutaneous CT-guided enucleation of the nidus of the osteoid osteoma
with additional sclerotherapy is a good alternative method, especiall
y in the region of the femoral neck.