• Joseph Antoine Mouawad, Mohamad Omar Youssef Honeine, Joe Georges Ghanimeh, Perla Naji Audi, and Khalil Tanios Khalil.
• Lebanese American University Medical Center-Rizk Hospital, LAU Gilbert and Rose-Marie Chaghoury School of Medicine, Beirut, Lebanon.
• Medicine (Baltimore). 2023 Aug 4; 102 (31): e34490e34490.

RationaleOsteoid osteoma is a relatively common benign bone-forming lesion that often occurs in young adults with a predilection for the lower limbs and spine. It is characterized by the formation of osteoid tissue, a precursor to bone, and can cause pain and restricted mobility in affected areas. Osteoid osteoma of the hand and fingers is rare, thus representing a diagnostic challenge. A written informed consent was provided from the patient's father for the publication and sharing all images and clinical data concerning the patient.Patient ConcernsWe are reporting a case of an 11-year-old girl who presented with persistent pain and swelling in her left index finger, as well as limited mobility, over the course of 1 year. Nonsteroidal anti-inflammatory drugs eased the pain, but it resurfaced once the medication was discontinued.DiagnosesA series of investigations, showed a lytic lesion at the second proximal phalangeal neck, with features indicative of osteoid osteoma.InterventionsExcision with bone grafting was performed as definitive therapy with pathological confirmation of the osteoid osteoma diagnosis. Nevertheless, the patient returned 2 years later with a recurrence of her previous symptoms, and further tests suggested a recurrence of osteoid osteoma. To address the recurrence, a modified open thermoablation technique was used. Thermoablation is a minimally invasive procedure that uses heat to destroy the tumor cells, and it has been shown to be effective in treating osteoid osteoma. The modified open approach involves making a small incision to access the tumor and delivering heat directly through a previously CT-guided inserted Kirschner wire to the affected area.OutcomesThe patient reported no pain at 1 month and 1 year after the surgery, with no radiological signs of recurrence, indicating complete excision of the lesion.LessonsOverall, this case highlights the challenges of diagnosing and treating osteoid osteoma in the hands and fingers. Further research is needed to better understand the underlying causes, potential risk factors, and optimal treatment for osteoid osteoma recurrence.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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