Osteoid osteoma is a rare occurrence in the hand, especially in children. We report here a rare case of a 12-year-old boy complaining of growing painful swelling of the middle phalanx of the third finger that had started 3 months earlier and had not responded to anti-inflammatory medication. Based on the clinical findings and plain radiographs, osteomyelitis or Ewing's sarcoma was suspected. However, MRI revealed the typical characteristics of osteoid osteoma. The lesion was excised, and the histological examination confirmed the diagnosis. We make a brief review of the literature concerning this uncommon localization and discuss the differential diagnosis and treatment modalities.
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