Permanent hip deformity can occur in this stage. It is important to note that plain radiographs may lag behind the progression of the disorder by as much as 3-6 months. Radionuclide bone scans are much better because early ischemia and avascular necrosis are depicted as decreased localization's of isotope. Osteoid osteoma is typically seen in older children and adolescents and exhibits a male predominance. Radiographs and CT scans demonstrate an osteolytic area surrounded by densely sclerotic reactive bone .
Bone scans reveal hot spots .
The site is usually less than 1 cm in diameter and arises at the junction of old and new cortex. Pathologically the lesion is highly vascularized fibrous tissue with an osteoid matrix and poorly calcified bone spicules surrounded by a dense zone of sclerotic bone. The involved extremity should also be carefully examined for deformity, swelling, crepitus, discoloration, and open wounds. A primary concern in any evaluation is a distal neurovascular compromise, which may require immediate surgical intervention. An open reduction is an operative reduction in which pins are fixed into the separate fragments to promote proximity for healing.