Spinal Osteoid Osteoma and scoliosis: who is the painful?

Ten-year-old girl was referred to our clinic for back pain and stiffness of the spine. X-ray of the spine showed a dorsal scoliosis with no other abnormality (figure 1a). Computed Tomography (CT) showed the nidus in right pedicle of the 3rd lumbar vertebra (figure 1b). The diagnosis of Osteoid osteoma was retained and confirmed after surgical resection and pathological examination. Osteoid osteoma (O.O) accounts for 10 % to 20 % of benign bone tumors [1]. Up to 25% of all O.O are found in the spine. Two thirds of spinal O.O manifest as painful scoliosis [2]. The diagnosis of the tumor is usually delayed because easily missed on standard X-ray investigation. Systematic CT or MRI with dynamic contrast would be recommended for young patients presenting with painful scoliosis [3].