Osteoid Osteoma

A small and noncancerous bone tumor where the cells in the tumor, called osteoblasts, make new bone. There is no risk of the disease spreading.

Screen Shot 2022 08 19 At 11.26.50 AM

What is an Osteoid Osteoma?

A small and noncancerous bone tumor where the cells in the tumor, called osteoblasts, make new bone. It is almost always very painful and the pain is usually turned off by taking aspirin or NSAIDS. They are very irritating to the bone and result in significant swelling in the bone and surrounding tissues. 

Who is usually affected?
Who is usually affected?
  • • Most common in the second decade of life, with 75% of patients younger than 25 years old. 
  • • It is rarely seen in patients over 30 years old. 
  • • Males are affected 3x more than females.
  • • The cause is unknown.



Common Bones Involved
Common Bones Involved
  • • Common in long bones of the lower extremities, including the femur and tibia. 
  • • Most common in the femur, at the top of the femur. 
  • • When it occurs in the spine it can cause scoliosis (spinal curvature). 
Signs and Symptoms
Signs and Symptoms
  • • Signs and symptoms include pain that is often worse at night, pain that is relieved by aspirin or NSAIDs, swelling, and sometimes, but not always, a lump.
  • • Usually a single lesion that is very painful and is 2 cm in size or smaller.
Biological Behavior
Biological Behavior
  • • A benign (noncancerous) bone tumor where the cells in the tumor called osteoblasts make new bone. 
  • • It looks identical under a microscope to an osteoblastoma. An osteoblastoma is a rare, benign aggressive bone forming tumor that continues to grow and destroy bone.
  • •  They are usually anywhere from a few millimeters in size up to 2 cm. The growth of an osteoid osteoma is limited and does not grow larger than 2 cm. 




  • • It can be difficult to diagnose especially when it's small and adjacent to a joint. In some instances, children are diagnosed as having juvenile rheumatoid arthritis because of the extensive swelling in the joint and can go a long time without an accurate diagnosis. 
  • • Scans include X-ray, CT, MRI, Bone scans. When it is very small and only a few millimeters it can be difficult to see on an Xray and MRI. The MRI usually shows extensive swelling around the tumor that can make it difficult to see the actual tumor on the MRI.
  • • The diagnosis is often confirmed with a biopsy, which means taking a sample of tumor and having it analyzed under a microscope by a pathologist.

Risk to your limbs

As the tumor slowly grows, the bone is weakened and you are at an increased risk of breaking the bone due to the tumor (called a pathological fracture). They may also spread to your lungs or other bones.

Radiographic imaging is used to help form a diagnosis. These include X-Ray, MRI, CT and Bone Scans

An example of an osteoid osteoma is shown.

18B) Osteoid Osteoma Case 2 MR COR PD FATSAT LEFT

Treatment of Osteoid Osteoma

Treatment is usually with minimally invasive percutaneous CT guided radiofrequency ablation for osteoid osteomas in the long bones, pelvis and sometimes the spine. If not causing any symptoms, it may be recommended that the tumor be left alone. 

I've seen many doctors and I can confidently attest Dr. Wittig is the preeminent orthopaedic specialist. He is genuinely kind and caring, as he demonstrated by completely addressing my concerns and compassionately relating to what I was dealing with. He clearly outlined the plan of attack, and recommended the two additional doctors who would become part of my 'team'. Dr. Wittig was so effective in allaying our fears and bringing us optimism. My surgery was significant, but I was up and walking the next day and back at the gym 5 weeks later. This is further testament to Dr. Wittig's skill. He saved my leg and my life, and I feel so very blessed to say he is my doctor. I have already recommended him to others, and I will continue to do so. I would trust him with my closest family and lifelong friends. BEST DOCTOR EVER.



Hey! I am Dr. Wittig.

Myself and my amazing team are dedicated to saving your life and your limb. Losing a limb because of a tumor can be a terrifying experience. But, it does not have to be the only option. I’ve spent 20+ years as a Board-Certified Orthopedic Surgeon and Orthopedic Oncologist.

I’ve devoted my career to helping children and adults afflicted with bone and soft tissue masses by performing complex limb saving surgeries. Most patients can have their limb saved, which may require innovative techniques.

Patients afflicted with musculoskeletal tumors have complex conditions that are best taken care of at large hospitals. I am the Chairman of Orthopedics and Chief of Orthopedic Oncology at Morristown Medical Center. My philosophy is a multidisciplinary team approach, working together to tailor treatment to individual patients. Education and research are essential to my practice, providing the best setting for extraordinary patient care. Because of this, we have some of the top results in the country.