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Osteoid osteoma is a benign tumour of bone that rarely localises in the carpal bones. Its treatment by curettage and bone grafting is considered to be curative and its recurrence is thought to be rare.

We report a case of an osteoid osteoma of the lunate, which recurred seven years after the initial operation. Recurrent osteoid osteoma of the lunate bone has not been reported in the literature. We present this case report for its atypical presentation and diagnostic difficulty and also to alert the readers of the possibility of an osteoid osteoma as a cause of the chronic unexplained wrist pain in young adults.

The occurrence of osteoid osteoma of the carpus is rare, particularly of the trapezoid. We present a case of a ten-year-old girl with osteoid osteoma of the trapezoid in whom surgical excision of the lesion was successful. Useful information for the diagnosis of the lesion was mainly provided by dynamic magnetic resonance imaging.

Osteoid osteoma in the wrist and hand region is an uncommon but severely symptomatic primary bone tumour. We report the case of a professional athlete with a radial styloid osteoid osteoma who presented with significant wrist pain and stiffness resembling arthritis for which she was treated initially. The symptoms started after a fall on the outstretched hand and significant delay in the diagnosis occurred. Following detailed imaging evaluation of the tumour site excision biopsy was curative.

Osteoid osteoma of the distal phalanx is very rare. We describe a case of osteoid osteoma of the distal phalanx of the ring finger with clubbed finger deformity that improved after tumour removal. A 50-year-old left-handed man presented with a history of right ring finger pain without any trauma. The distal phalanx of the ring finger had tender, redness, and a clubbed finger deformity. Plain radiography indicated a circular radiolucent area in the centre of the lesion. Computed tomography and gadolinium enhanced magnetic resonance imaging indicated presence of a nidus. The lesion was removed via the transungual approach. Histopathological examination confirmed the presence of an osteoid osteoma. His pain was immediately relieved after surgery. At the 2-year followup, he had no pain and the clubbed finger deformity had improved. In cases where clubbed finger deformity involves only one finger, the possibility of chronic osteomyelitis or osteoid osteoma should be considered.

Introduction: Osteoid osteoma is a benign painful bony lesion that often affects children and young adults. It is 3% of all bone tumors. It may result in growth disturbance, bony deformity, joint swelling and contractures. Long bones especially of the lower limb are the most commonly affected regions. During the initial period, the resection of nidus was performed by open surgery where a bone block was removed. This was followed by development of computed tomography (CT)-guided procedures for complete removal of nidus using various percutaneous techniques. These include CT-guided radiofrequency ablation (RFA) or trephination. If these lesions are near any important vascular structures, it becomes difficult to use RFA due to risk of injuring them. While the results of RFA are well studied, percutaneous trephination is still not widely researched.

Objectives: We evaluated the results of 14 cases of osteoid osteoma treated with percutaneous drilling resection of the nidus under CT guidance and discussed the positive and negative impact of the same.

Material and Methods: We included 14 patients who presented, from October 2017 to September 2020, at a tertiary level health care center. The diagnosis was established by clinical as well as imaging modalities. The patients underwent CT scan and the exact site was localized. Safe zone for percutaneous drilling was identified using contrast for vascular bundle. Percutaneous drilling was done using 8 mm reamer and complete lesion was removed under CT guidance. Patients were followed up for 2 years after the procedure and the final results were obtained in terms of pain, functional ability of limb and recurrence.

Results: 13 out of 14 patients were pain-free at the end of the follow-up. One patient did have some pain after 1 year and on repeat imaging, there were changes suggestive of recurrence. The success rate was thus 13/14 patients (92.8%). The mean pre-operative pain score improved from 2.3 (range, 0–4) to 4.85 (range, 4–5) after procedure. There was no functional deficit of the limb recorded at the end of final follow up.

Conclusion: CT-guided percutaneous trephination is a cost-effective alternative to available treatments protocols for Osteoid osteoma. Although newer techniques such as radio-frequency ablation are available, they are neither easily accessible nor affordable for the masses in developing countries.

We describe a case of osteoid osteoma in the radial styloid of a 37-year old man mimicking de Quervain's disease. The exact diagnosis was made with CT examination and confirmed by histological evaluation of the tumour. The lesion was removed by curettage and symptoms were resolved rapidly thereafter. There was no sign of recurrence at one year follow-up.

Osteoid Osteoma is benign bone forming tumor which commonly occurs in long bones of lower limb. Presence of these rare tumors in the distal phalanx of the digits of the hand is considered a rare phenomenon. In hand, they usually present as chronic pain, swelling, nail enlargement and increase in size of digit. Diagnosis is challenging with clinical examination and usual imaging modalities and often confused with glomus tumor, enchondroma, infection, trauma and rheumatic disease. Surgical excision of the tumor, if present in hand, is the treatment of choice that aids in coming to the exact diagnosis too. The aim of the paper is to report yet another uncommon case of osteoid osteoma of distal phalanx of middle finger mimicking glomus tumor.

A relatively rare tumor, osteoid osteoma most commonly affects the lower extremity. In 10% of the cases, it can affect the hand and wrist. We present a case of osteoid osteoma in the proximal phalanx of ring finger that was initially misdiagnosed as a soft tissue lesion. The soft tissue lesion was resected, but the symptoms recurred shortly thereafter, leading to repeat diagnostic workup. Despite X-rays, magnetic resonance imaging, and tissue biopsy, the diagnosis remained elusive until surgical re-exploration. Based on the lessons learned from this case and the experience reported in literature, we discuss the intricate nature of osteoid osteoma diagnosis in the hand, the obstacles often encountered, and how to approach these challenging patients in a stepwise and critical fashion.

Osteoid osteoma is one of the commonest benign bone tumour of adolescence. Diagnosis is based upon the typical clinical features, site of occurrence and imaging findings. Occurrence of this lesion in an atypical site is associated with delay in diagnosis and challenges in management. We present a rare case of osteoid osteoma in scaphoid in a 14-year-old girl. Comprehensive work-up using radiograph, computerized tomography (CT), magnetic resonance imaging and Tc⁹⁹-multidetector methylene diphosphonate (MDP) bone scan was used to make the correct diagnosis over other conditions with similar presentation like de Quervain tenosynovitis, intersection syndrome and inflammatory arthropathies. We also describe the treatment using CT-guided percutaneous radiofrequency ablation of this lesion and a brief literature review regarding the incidence of this lesion and treatment options available.

Level of Evidence: Level V (Therapeutic)