Intraoperative radioactive localization of an osteoid osteoma: a useful variation in technique

Only complete excision of the nidus of an osteoid osteoma can guarantee cure. Localization of the nidus by using a gamma camera in theatre (Rinsky et al, 1980) is cumbersome and inaccurate in delineating how much bone should be excised. The use of a sterilizable, portable scaler-ratemeter (Colton & Hardy, 1983) provides good results, but the equipment is expensive to buy and maintain. The use of a scintillation well counter outside theatre to measure counts from bone punch biopsy specimens in and around the suspect area has also been reported (O'Brien et al, 1984). However, up to 24 specimens were required and operative time must have been substantially prolonged. When a patient presented to our hospital with a probable osteoid osteoma we devised a variation on the above techniques which is reasonably speedy and only requires the type of gamma camera found in most nuclear medicine departments.