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Osteoid osteoma is an uncommon benign bone tumour. It develops in young people and involves their long bones, especially lower extremities. The affection of vertebral column is rare (10%) and sacrum is exceptionnally affected (2%). Osteoid osteoma should be included in the differential diagnosis of any young patient with back pain. The tumor is the most common cause of painful scoliosis in young patients. In spite of typical symptoms the diagnosis is often delayed. Case Report: We report a case of a 6-year-old student girl who complained of chronic back pain worsening at night with non radicular left leg pain for several months duration and with no response to non-steroidal antiinflammatory drugs (NSAID). The physical examination objectived no temperature, no gibbosity, no limping, just a pressure tenderness of the sacral region. Biology and radiography of the pelvis was both normal. The CT scan and MRI showed a subperiosteal nodule with intra and extra development on S2 left lamina evoking osteoid osteoma. The patient went under a surgical excision through a posterior approach and intralesionnal excision of the nidus with minimal removal of bone. The histological study confirmed the osteid osteoma with a broad bony trabecular mesh and a small fibrovascular component identified in its central area. Complete resolution of back and leg pains was obtained within a short period and no recurrancy noticed at last follow-up. Conclusion: Osteoid osteoma is a relatively frequent benign bone tumor of osteoblastic origin. Atypical manifestations of osteoid osteoma are prone to diagnostic and therapeutic delays and errors and may cause diagnostic and therapeutic difficulties.

Sacral osteoid osteoma: a rare cause of back pain in childhood