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Case Report
Online Published: 03 Jan 2026
 


Atypical osteoid osteoma mimicking stress fracture in elderly female: a case report

Saad Ahmad Khan, Nayyar Rubab, Warda Ahmad, Syed Fakhar Raza, Hajra Safeer Farkhanda Gillani, Muhammad Babar Imran.


Abstract
Background: Osteoid osteoma is a benign bone tumor that typically affects young males. Its occurrence in older females is rare, often leading to diagnostic challenges due to atypical clinical and radiological features.
Case presentation: A 55-year-old female presented with a 6-month history of progressive nocturnal pain in the right thigh, which was partially relieved by nonsteroidal anti-inflammatory drugs. Initial X-ray imaging revealed subtle cortical lucency with mild surrounding sclerosis, initially suggestive of a stress fracture.
Investigations: Three-phase bone scintigraphy demonstrated focal increased uptake in the affected region. Subsequent SPECT/CT imaging confirmed increased Technetium-99m Methylene Diphosphonate uptake corresponding to a cortical nidus with central lucency and peripheral sclerosis, consistent with osteoid osteoma.
Diagnosis: Based on clinical presentation and imaging findings, a diagnosis of osteoid osteoma of the right femur was established.
Discussion: This case underscores the diagnostic difficulty of osteoid osteoma in older adults, where the presentation may mimic stress fractures or other cortical lesions. Advanced imaging modalities such as SPECT/CT play a crucial role in accurate lesion localization and differentiation from other pathologies.
Conclusion: Recognition of atypical presentations of osteoid osteoma in older adults is essential to avoid misdiagnosis and unnecessary interventions. Advanced imaging techniques are invaluable for confirming the diagnosis and guiding appropriate management.

Key words: Osteoid osteoma, elder female, bone scintigraphy, SPECT/CT, stress fracture, cortical nidus.


 
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How to Cite this Article
Pubmed Style

Khan SA, Rubab N, Ahmad W, Raza SF, Gillani HSF, Imran MB. Atypical osteoid osteoma mimicking stress fracture in elderly female: a case report. Pak J Nucl Med. 2025; 15(1): 34-36. doi:10.24911/PJNMed.175-1759559449

Web Style

Khan SA, Rubab N, Ahmad W, Raza SF, Gillani HSF, Imran MB. Atypical osteoid osteoma mimicking stress fracture in elderly female: a case report. https://www.pjnmed.com/?mno=288126 [Access: January 11, 2026]. doi:10.24911/PJNMed.175-1759559449

AMA (American Medical Association) Style

Khan SA, Rubab N, Ahmad W, Raza SF, Gillani HSF, Imran MB. Atypical osteoid osteoma mimicking stress fracture in elderly female: a case report. Pak J Nucl Med. 2025; 15(1): 34-36. doi:10.24911/PJNMed.175-1759559449


Vancouver/ICMJE Style

Khan SA, Rubab N, Ahmad W, Raza SF, Gillani HSF, Imran MB. Atypical osteoid osteoma mimicking stress fracture in elderly female: a case report. Pak J Nucl Med. (2025), [cited January 11, 2026]; 15(1): 34-36. doi:10.24911/PJNMed.175-1759559449


Harvard Style

Khan, S. A., Rubab, . N., Ahmad, . W., Raza, . S. F., Gillani, . H. S. F. & Imran, . M. B. (2025) Atypical osteoid osteoma mimicking stress fracture in elderly female: a case report. Pak J Nucl Med, 15 (1), 34-36. doi:10.24911/PJNMed.175-1759559449


Turabian Style

Khan, Saad Ahmad, Nayyar Rubab, Warda Ahmad, Syed Fakhar Raza, Hajra Safeer Farkhanda Gillani, and Muhammad Babar Imran. 2025. Atypical osteoid osteoma mimicking stress fracture in elderly female: a case report. Pakistan Journal of Nuclear Medicine, 15 (1), 34-36. doi:10.24911/PJNMed.175-1759559449


Chicago Style

Khan, Saad Ahmad, Nayyar Rubab, Warda Ahmad, Syed Fakhar Raza, Hajra Safeer Farkhanda Gillani, and Muhammad Babar Imran. "Atypical osteoid osteoma mimicking stress fracture in elderly female: a case report." Pakistan Journal of Nuclear Medicine 15 (2025), 34-36. doi:10.24911/PJNMed.175-1759559449


MLA (The Modern Language Association) Style

Khan, Saad Ahmad, Nayyar Rubab, Warda Ahmad, Syed Fakhar Raza, Hajra Safeer Farkhanda Gillani, and Muhammad Babar Imran. "Atypical osteoid osteoma mimicking stress fracture in elderly female: a case report." Pakistan Journal of Nuclear Medicine 15.1 (2025), 34-36. Print. doi:10.24911/PJNMed.175-1759559449


APA (American Psychological Association) Style

Khan, S. A., Rubab, . N., Ahmad, . W., Raza, . S. F., Gillani, . H. S. F. & Imran, . M. B. (2025) Atypical osteoid osteoma mimicking stress fracture in elderly female: a case report. Pakistan Journal of Nuclear Medicine, 15 (1), 34-36. doi:10.24911/PJNMed.175-1759559449




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