Osteoid osteoma: an evaluation of diagnostic modalities.

Significant delays still occur in the diagnosis of osteoid osteoma yet in two-thirds of cases the plain films show the characteristic features; unfortunately, early changes may be overlooked. A diagnostic approach is proposed for the investigation of focal bone pain in young individuals. Plain radiography is followed by isotope bone scanning with, if possible, a bone blood flow study. Tomography is sometimes helpful in atypical cases. CT scanning is valuable in foci in the axial skeleton including the pelvis. Lesions in the appendages of the vertebrae should be sought in patients with painful scoliosis or lordosis of relatively recent onset.