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Medical History and Physical Examination

There are many aspects to the doctor's examination. Before a physical examination, your doctor will talk with you about your general health, as well as your symptoms, to get a good history of the problem.

During the physical examination, your doctor will look for tenderness over the bone and check your range of motion in the painful area.

Tests

Your doctor will order imaging and tissue tests to diagnose osteoblastoma.

X-rays. X-rays provide images of dense structures, such as bone. Results from the X-rays will help your doctor determine whether more imaging scans are needed.

(Left) An X-ray of an osteoblastoma on a patient's ring finger. (Right) An MRI scan of the same osteoblastoma shows the tumor mass in greater detail.

Other imaging tests. Your doctor may also request computerized tomography (CT) scans, magnetic resonance imaging (MRI) scans, or bone scans to help further define the tumor. These scans can provide more detail, especially of soft tissues. They can also provide cross-sectional images.

A CT scan or MRI scan will show your doctor more precisely where the tumor is located and what its specific characteristics are.

Biopsy. A biopsy is often necessary to confirm an osteoblastoma diagnosis. In a biopsy, the doctor takes a tissue sample of the tumor and examines it under a microscope. Your doctor may give you a local anesthetic to numb the area and take a sample using a needle. Biopsies can also be performed in the operating room with a small surgical procedure.

Osteoblastoma and Osteoid Osteoma

Osteoblastoma is closely associated with another benign bone tumor: osteoid osteoma. Both tumors form abnormal osteoid bone material, and both occur more frequently in younger people, particularly males.

These are the key differences between the two types of tumors:

• Osteoblastomas are usually over 2cm (1 inch) in size. Osteoid osteomas are smaller than osteoblastomas, and they do not grow.
• Pain from osteoid osteoma often worsens at night, but it can be relieved with NSAIDs, like ibuprofen. Osteoblastomas do not typically cause night pain, and the pain does not respond as well to NSAIDs.
• Osteoblastoma requires surgery to remove the growing tumor. Osteoid osteoma does not require surgery if the associated pain can be managed with NSAID treatment.

Curettage and Bone Grafting

In this procedure, the tumor is scraped out of the bone.

• In some cases, the hole is filled with a bone graft — this is bone taken from a donor (allograft) or from another bone in your body (autograft).
• Your doctor may also use a bone graft substitute or bone cement to fill the hole.
• Sometimes, your surgeon may need to support the bone using plates and screws

Spine Tumors

Treatment for tumors in the arms and legs is usually straightforward; however, there may be more challenges when the tumor is located in the spine.

After a tumor is removed from the spine, a spinal fusion may be needed to support the area. Spinal fusion is essentially a "welding" process. The basic idea is to realign and fuse together the weakened spinal bones so that they heal into a single, solid bone.

En Bloc Resection

In some cases, the best surgical option is to remove the entire tumor and reconstruct the bone. This is most common for:

• A large, destructive tumor
• Cases with multiple recurrences (meaning, the tumor has grown back after removal more than once)

Ablation

If the osteoblastoma cannot be safely removed with surgery, your surgeon may consider:

• Cryotherapy (freezing the tumor)
• Radiofrequency ablation (burning the tumor)

Radiation Therapy and Chemotherapy

These treatment options are not recommended for osteoblastoma except in rare circumstances. For example, if the tumor is located in the spine and the surgeon cannot safely remove the entire tumor, radiation therapy is sometimes recommended.