A Rare Case of Osteoid Osteoma of the Medial Cuneiform Bone at Tibialis Anterior Insertion Confirmed by Bone Scan SPECT/CT.

Abstract

A 34-year-old man presented with progressive foot pain that was initially on the medial soft tissue but eventually localized to the medial side of midfoot. Despite undergoing various imaging tests and conservative treatments over 2 years, the patient remained undiagnosed. After 6 months, soft tissue and bone involvement were observed on the medial cuneiform. A needle biopsy was inconclusive. Since bone tumor is rare in the medial cuneiform, the patient was referred to our department for 99m Tc-MDP bone scan. The imaging and clinical findings suggested osteoid osteoma as the likely diagnosis, which was confirmed as intraarticular nidus under tibialis anterior attachment, after surgical resection and pathological examination.