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Osteoid osteoma: the role of radionuclide bone imaging, conventional radiography and computed tomography in its management.

CASE PRESENTATION A 16-yr-old male presented with a complaint of wors ening lower back pain. The pain was exacerbated by exercise, radiated to both sides, and was severe enough to limit his activities. His primary physician diagnosed the problem as spondylolysis. His physical examination at that time was unremarkable except for focal tenderness in the L4-5 region of the back and mild lumbar paraspinal muscle spasm. He was treated with bed rest and non-steroidal anti-inflammatory agents. The patients's past medical history was remarkable only for surgery for pyloric stenosis at the age of 12 yr. On physical examination, the patient was a healthy appearing white male with normal vital signs, gait and posture. Examination of the back revealed a mild lumbar scoliosis with the convexity to the left. Tenderness was felt over the lower lumbar vertebral region with mild paraspinal muscle spasm. Pain was noted on straight leg raising radiating to the right side. Neurological examination re vealed normal lower extremity motor strength, sensation and deep tendon reflexes.