The occurrence of osteoid osteoma in the hand is rare, and the rarest of all locations is the terminal phalanx. An osteoid osteoma of the terminal phalanx of the middle finger in a twenty-four-year old woman is described. This case illustrated the very typical clinical and x-ray features of an osteoid osteoma, which made diagnosis and treatment of this rare clinical entity straightforward. On pathological examination, a bundle of nerve fibres was found in the lesion, an explanation that the pain of this tumour may have been mediated by the nervous system via the nerve fibre.
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