Which statement best describes the typical presentation of osteoid osteoma?

Which statement best describes the typical presentation of osteoid osteoma?

• A. Painful, worse at night, relieved with aspirin
• B. Painless swelling
• C. Painful with activity only
• D. Neurovascular deficits

Answer: (A)

Osteoid osteoma typically presents with focal, intense pain that is worst at night and markedly relieved by nonsteroidal anti-inflammatory drugs like aspirin. This classic pattern comes from the nidus producing large amounts of prostaglandins, especially PGE2, which drive the nocturnal, aching pain. NSAIDs inhibit prostaglandin synthesis, so the pain improves with aspirin, which is a characteristic feature of this tumor.

Painless swelling would point toward a lesion like a benign osteoma rather than an osteoid osteoma. Pain only with activity suggests other conditions such as a stress fracture or overuse injury, and neurovascular deficits are not typical of this tumor.