Scaphoid Osteoid Osteoma in a Pediatric Patient: A Case Report and Review of Diagnostic Pitfalls and Management Strategies.

Osteoid osteoma (OO) of the scaphoid is an uncommon entity, particularly in pediatric patients, where diagnosis is often delayed due to its rarity and overlapping presentation with more common wrist pathologies. We report the case of a pediatric athlete with persistent wrist pain initially diagnosed as a scaphoid fracture. Imaging progression from radiographs to MRI suggested fracture, but confirmatory CT revealed a 5-mm radiolucent lesion with central mineralization, consistent with OO. Surgical excision via volar approach was performed due to intraosseous lesion location and proximity to articular surfaces, with demineralized bone matrix placement and no fixation required. Postoperative recovery was notable for resolution of pain and functional restoration by 2 months. This case highlights the importance of considering OO in atypical locations and the role of CT for definitive diagnosis when MRI is inconclusive. Early recognition can expedite management, reduce morbidity, and prevent long-term sequelae in pediatric athletes.