This article describes a patient with a 10-year history of persistent
ankle pain. Differential diagnosis included osteoid osteoma and anteri
or ankle impingement. This patient subsequently underwent arthroscopic
excision of a lesion on the talar neck following a complete radiograp
hic work-up, which was nondiagnostic. The diagnosis of osteoid osteoma
was finalized upon pathologic study of the arthroscopic shavings. The
use of a motorized instrument for excision did not preclude pathologi
c evaluation of the specimen. Therefore, in an accessible location on
the talar neck, arthroscopic excision of an osteoid osteoma can be per
formed.