Osteoid osteomas of the foot and ankle are relatively rare and notoriously
difficult to diagnose. Juxta-articular osteoid osteomas are more difficult
to treat and often have a significant delay in diagnosis. We report a case
of a juxta-articular osteoid osteoma of the tibial plafond. Once the diagno
sis was made, excisional biopsy was performed percutaneously under computed
tomography (CT) guidance as an outpatient in the radiology suite. The pati
ent had complete resolution of symptoms and remains pain free at two years
follow-up. CT guided resection can be a lower morbidity and more cost effec
tive technique to treat this lesion than traditional methods.