Osteoid osteoma is a benign tumor that may occur in almost any part of any
bone. Diagnosis can be difficult, particularly when it is intra-articular.
In these cases, osteoid osteoma may present initially with symptoms suggest
ive of inflammatory arthritis, degenerative joint disease, neoplasm, or inf
ection
We report a ease of intra-articular osteoid osteoma in a teenager who prese
nted with a monoarthritis of the elbow. The patient did not have a typical
pattern of pain, did not have the typical relief with anti-inflammatory age
nts, and misinterpretation of the radiographs led to a delay in the diagnos
is and definitive treatment. Surgical excision confirmed the diagnosis and
resulted in resolution of the monoarthritis.
Intra-articular osteoid osteoma must be taken into account in cases of unex
plained chronic monoarthritis, with a sterile and relatively noninflammator
y synovial. fluid. A definitive diagnosis depends on surgical excision and
histologic confirmation. A high index of suspicion is necessary to make the
diagnosis.