# Sclerosing Intracancellous Osteoid Osteoma Presenting as a Painless Swelling of the Middle Phalanx in the Toe of a 15-Year-Old Footballer

## TL;DR

A 15-year-old footballer had a rare case of osteoid osteoma in his toe, which presented as a painless swelling and was confirmed through surgery and histopathology.

## Contribution

This case report highlights the unusual presentation of osteoid osteoma in the toe as a painless swelling, emphasizing the need for thorough investigation.

## Key findings

- The patient presented with a painless swelling in the middle phalanx of the third toe.
- Radiological and surgical findings confirmed a sclerosing intracancellous osteoid osteoma with a central sclerotic lesion.

## Abstract

Osteoid osteoma (OO) most commonly affects the cortices of long bones and rarely involves the toes, where it typically presents with swelling and pain. Radiological evaluation can often pose a diagnostic challenge. We report the case of a boy with a painless swelling of the middle phalanx of the third toe. Radiographic assessment using plain X-rays, MRI, and CT revealed a centrally located sclerotic lesion with a barely visible nidus. A bone scan demonstrated increased uptake at the lesion site. Surgical intervention was performed to remove the sclerotic lesion, followed by reconstruction of the phalanx using an autologous bone graft. Histopathological analysis confirmed the diagnosis of OO. Although OO of the toes is uncommon, it may present as painless swelling. A centrally located sclerotic lesion in the phalanx warrants thorough investigation and surgical management with pathological confirmation to ensure accurate diagnosis.