Osteoid osteoma causing chronic hip pain in a child

Osteoid osteoma is a common benign tumor of bone that occurs predominantly in children and young adults. The classical clinical presentation is throbbing pain at night, relieved by mild analgesics. Confusion can arise when the lesion is near a joint because symptoms can mimic those of arthritis or synovitis. We describe a 7-year-old girl with 7-month duration of pain in the right hip with a limp and a bone scan finding of increased tracer activity in the right hip area. She was placed on naproxen; however, during 6 months of monthly follow-up visits she continued to have right hip irritability. Although routine x-rays were normal, computerized tomography (CT) revealed osteoid osteoma of the right femoral neck that was successfully removed using percutaneous excision under CT guidance.