(Drs. Younge and Ilyas reply)
=============================

* Derek Younge
* Imran Ilyas

We thank Drs. Munk and Huk for dragging us into the modern world! There is no doubt that radiofrequency ablation is now the treatment of choice for osteoid osteoma, if available. We admit to giving it poor coverage in our article.

We initially started our study on non-steroidal anti-inflammatory drug treatment for osteoid osteoma because we felt that medical treatment as championed by Kneisl and Simon1 was underused and we had observed that most patients were still being subjected to open surgery. We believe that patients should at least be given the choice, and that medical treatment would be the treatment of choice in situations where surgery would be difficult or hazardous, such as in the neck of the femur.

During the time of our study, radiofrequency ablation was proving its value, and there is little doubt now that it is the preferred treatment as it is minimally invasive, safe, effective and easy for an experienced operator to perform.

We think that the point we made about giving the patient the option of medical treatment or surgery is still valid in hospitals where radiofrequency ablation is not available, as in many developing countries. Medical treatment can also be used during a long waiting period, as is seen often in the Canadian medical system and in the 10% of cases where radiofrequency treatment fails.

## Reference

1.  Kneisl JS, Simon MA. Medical management compared with operative treatment for osteoid osteoma. J Bone Joint Surg Am 1992;74(2):179–85.
    
    [Abstract/FREE Full Text](http://canjsurg.ca/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NjoiamJqc2FtIjtzOjU6InJlc2lkIjtzOjg6Ijc0LzIvMTc5IjtzOjQ6ImF0b20iO3M6MTk6Ii9janMvNDYvMS82MS4xLmF0b20iO31zOjg6ImZyYWdtZW50IjtzOjA6IiI7fQ==)