Hip preservation in crisis: total hip replacement for osteoid osteoma-induced degeneration in a young adult

Osteoid osteoma is a small, benign tumor known for causing severe pain, especially at night. Intra-articular osteoid osteomas are rare and often misdiagnosed due to overlapping symptoms with other joint disorders like osteoarthritis or synovitis. These tumors require advanced imaging for accurate diagnosis and may necessitate surgical intervention when conservative treatments fail. A 22-year-old female presented with a four-year history of left hip and loin pain, initially treated with NSAIDs. Her symptoms progressively worsened, leading to imaging studies that revealed a sclerotic lesion in the hip joint. A biopsy confirmed osteoid osteoma, and due to the extent of joint damage, total hip replacement (THR) was performed. Postoperative recovery was excellent, with full functional restoration and no complications. This case illustrates the diagnostic and therapeutic challenges of intra-articular osteoid osteomas. THR proved to be a successful treatment in restoring function and alleviating pain, underscoring the need for early diagnosis and individualized surgical management in advanced cases.