DOI: https://doi.org/10.36347/sjmcr.2026.v14i09.001

Pages: 1944-1947

Background: Osteoid osteoma is a benign bone tumor commonly affecting young adults, with the femur and tibia being the most frequent sites. Humeral involvement is uncommon and may lead to delayed diagnosis. Case Presentation: A 30-year-old man presented with severe nocturnal pain in the distal third of the left arm for one year, causing significant sleep disturbance. The pain persisted despite analgesics and nonsteroidal anti-inflammatory drugs but was markedly relieved by aspirin. Radiographs showed a cortical radiolucent nidus with surrounding sclerosis, and CT confirmed an osteoid osteoma of the distal humerus. The lesion was completely excised under fluoroscopic guidance using a high-speed burr, and the cortical defect was filled with an autologous cancellous bone graft. Histopathology confirmed the diagnosis. Complete pain relief was achieved from the first postoperative day, with no functional impairment or recurrence during follow-up. Discussion: Humeral osteoid osteoma is uncommon and can be overlooked because of its atypical location. Recognition of characteristic nocturnal pain and identification of the nidus on CT are essential for diagnosis. Although minimally invasive techniques such as radiofrequency ablation are increasingly used, open excision remains an effective option for accessible lesions, allowing complete removal and histological confirmation with excellent clinical outcomes.