Atypical presentation of an osteoid osteoma in a child

Osteoid osteomas are benign bone tumors that most commonly involve the long bones of the lower extremities, but do occur in the spine with some frequency. Patients with lesions in the spine typically present with back pain, scoliosis, and, less commonly, varying degrees of radicular leg pain. We report the case of a child with complaints of nonradicular leg pain. A combination of plain radiographs, scintigraphy, and axial imaging showed a lesion in the sacral spine consistent with an osteoid osteoma. After failed medical management, our patient was treated with intralesional excision, with complete resolution of symptoms.