An osteoid osteoma in the anterior part of the body of the fourth cervical
vertebra occurred in a 22-year-old female. The patient's main complaint was
neck pain and occasional numbness of the extremities. The pain was relieve
d by analgesics. Plain radiography and a Tc-99(m) MDP bone scan showed a no
n-specific abnormality. CT suggested the pathological diagnosis with reason
able certainty. The unusual location of the lesion and the role of various
diagnostic modalities are discussed and the literature reviewed.