Osteoid osteoma: a diagnosis for radicular pain of extremities

Osteoid osteoma is a benign tumor commonly found in young patients. The most interesting feature of the tumor is its peculiar obvious pain. The intensity of pain produced by osteoid osteoma is unproportionate to its nature and size. Much has been written about the mechanism of this symptom of the tumor and the specific characteristics of the pain that can be misleading when appearing as radicular pain especially when some subtle neurologic signs and symptoms accompany the pain. In this article, 12 patients who were referred to our clinic with radicular pain and neurological signs and symptoms months after initiation of symptoms between 2000 and 2008 are presented. Of these 12 patients, most were first thought to have root compression disease before being referred to our hospital. Precise history taking and special attention to physical examinations led to a suspicion of osteoid osteoma. Plain radiographs, computed tomography, and bone scans indicated osteoid osteoma, and excisional biopsy confirmed its diagnosis. Osteoid osteoma should always be considered in young patients with radicular pain, even with subtle neurological signs and symptoms.