This article describes a patient with a 10-year history of persistent ankle pain. Differential diagnosis included osteoid osteoma and anterior ankle impingement. This patient subsequently underwent arthroscopic excision of a lesion on the talar neck following a complete radiographic work-up, which was nondiagnostic. The diagnosis of osteoid osteoma was finalized upon pathologic study of the arthroscopic shavings. The use of a motorized instrument for excision did not preclude pathologic evaluation of the specimen. Therefore, in an accessible location on the talar neck, arthroscopic excision of an osteoid osteoma can be performed.
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