after deroofing

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Hi,

Dr Manash Saha here from kolkata. Here are the images of a patient of osteoid osteoma. A lady in her fiftys presented to orthopod outside with pain , evaluated , diagnosed as OO AND DEROOFING WAS DONE ABOUT 6-7 WEEKS BACK. She is having recurrence of symptoms with frequent attacks of pain relieved by normal analgesics like paracetamol, sm hyphenac etc. Repeat xray show gross enlargement of lesion and MRI features are looking like ABC with soft tissue extension having fluid-fluid levels, dependent is haemorrhagic sp. at t1. No other symptoms.Now questions are-

A. Wether it is an OO (histologically proven) at all or ABC which is cortical (not known to me)

B. Wether RFA advised or surgery is better option 

Pre and post images are in different mails. Waiting for your valuable opinion.

Manash Saha

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