Osteoid osteoma of the elbow as a cause of both elbow arthropathy and ipsilateral periscapular pain

Osteoid osteoma is associated with chronic aching pain. A sclerotic ring and central nidus are the characteristic features on X-ray and CT scan. When these are absent, the diagnosis may be delayed. Juxta-articular lesions in particular may lack typical radiological features and delay in diagnosis may be associated with arthropathy, which may initially be reversible. We report the case of an osteoid osteoma of the elbow, which was exceptional in being associated with severe periscapular pain, as well as an exceptional delay in diagnosis. Both the elbow pain and the periscapular pain were temporarily relieved by aspirin and were permanently abolished with ablation of the elbow lesion. We recommend the use of early radioisotope scan and consideration of aspirin sensitivity, in recognising the diagnosis where typical radiological features are not present.