 Following a discussion of the procedure with the patient and her family, including its risks, benefits, alternatives and steps to prevent infection, informed written consent was obtained and documented in the patient's chart. The time-outform was completed to confirm patient identity and side/type of procedure. All operators present for the case performed standard preprocedural prep including hand washing, sterile gloves, mask and cap. The patient was prepped and draped in the usual aseptic fashion. Local anesthesia over the target area was obtained by 1% lidocaine.Targeted CT examination demonstrates a lucent lesion with sclerotic borders within the right femoral head neck junction corresponding to the findings on recent CT and MRI examinations. The imaging findings are most consistent with that of an osteoid osteoma. Using CT guidance, a 13-gauge OnControl core biopsy needle was advanced into the lesion and 2 attempted biopsies were performed. The specimens were obtained and placed in 10% formalin. Subsequently, CT guidance was used to advance an AngioDynamics SDE RFA probe into the lesion. The lesion was heated to 70-80 degrees centigrade for 2:30 minutes at 35 W. The RFA probe was removed.The core biopsy specimens were hand carried to the Surgical Pathology labThe patient complained of right hip pain following the procedure but otherwise had no immediate complications. This was addressed with IV pain medication in conjunction with anesthesiology as documented in the in the medical record. A discussion was had with the family regarding the patient's pain which is thought to most likely be the result of the biopsy attempts and difficulty seeding the access system prior to ablation also a component of synovitis following the ablation may be a contributing factor. Routine post procedure instructions were communicated to the patient and her family.ESTIMATED BLOOD LOSS: Less than 5cc. An adhesive bandage was placed on the patient's skin.
CT-guided biopsy and radiofrequency ablation of right femoral neck osteoid osteoma.