Answer:
Osteoid osteoma is a benign bone lesion which typically presents in the late second or early third of life with a deep, dull constant ache which is often relieved with NSAID’s. They comprise 10-12% of all benign bone tumors and about 7% of all osteoid osteomas occur in the hand, usually in the proximal phalanx and carpus. Involvement of the middle phalanx is rare. Most patients are between 5-25 years of age with a peak in the teen years. The male-to-female ratio is 3:1. Physical exam usually shows well-delineated tenderness with swelling. If the distal phalanx is involved then frequent pulp swelling and nail deformity may be seen. Some osteoid osteomas are painless with the primary complaint being swelling. The classic radiographic finding is one of reactive sclerosis surrounding a central radiolucent nidus less than 1 cm in diameter. The well-circumscribed nidus contains osteoid and trabeculae of immature woven bone. Treatment is surgical excision of the nidus, although long-term NSAIDs has been used when excision might produce excessive morbidity.