Another Rare differential diagnosis of infant limping: A case of talar osteoid osteoma

Abstract

Osteoid osteoma is a benign osteogenic bone lesion, typically found in patients aged between 5 to 25 years. It is recognized by its clinical picture in the form of a regional nocturnal pain that is relieved by NSAIDS, and by its characteristic radiographic appearance as a small (<1.5 cm in diameter) lesion with a sclerotic margin and radiolucent nidus. Osteoid osteoma is rare in the pediatric population younger than 5 years-old. The differential diagnosis in this age group for lytic lesions osteomyelitis, osteochondroma, stress fractures, histiocytosis, bone cysts, and malignancies. We present a case of 4-year-old boy presented with a 1-month history of limping, and right ankle pain diagnosed with osteoid osteoma. Treatment consisted of simultaneous intralesional biopsy and radiofrequency ablation under fluoroscopic guidance. We report this case for the rare occurrence of an osteoid osteoma in a very young patient (<5 years-old), its atypical location in the talus, and its presentation as pain not relieved by NSAIDS. The inclusion of this pathology in the differential diagnosis in the pediatric age group leads to an effective and simple treatment, and avoids unwarranted and costly workup and interventions.

Keywords

• Level V