Painless osteoid osteoma of tibia in a fifteen-month-old child: a rare case report

Abstract

Painless osteoid osteoma is an uncommon entity. We report a unique painless osteoid osteoma of proximal tibia in a 15-month-old child. Patient had atypical painless osteolytic lesion with minimal periosteal reaction for which he was initially treated as chronic osteomyelitis at a secondary care hospital. A correct diagnosis could be made on the basis of characteristics of CT scan and bone scan features. Wide excision of tumor was done, and patient had complete recovery with no recurrence during last 2 years of follow-up. To our knowledge, painless osteoid osteoma at an age of 15 months (lowest in literature) affecting metadiaphyseal portion of long bone (very rare) with atypical radiological (radiographs) features has not been reported previously in the world literature. Both bone scan and CT scan play an important role in early diagnosis and treatment to minimize the morbidity particularly in the presence of subtle or atypical radiological feature of osteoid osteoma. But bone scan may be preferred over CT scan for diagnosis particularly in young patients to avoid radiation exposure of CT scan.