ABSTRACT
Osteoid osteoma is rarely located in the carpal bones. The clinical presentation is pain exacerbated at night but there is some unusual presentation that makes the diagnosis difficult. The aim of this article is to present the rare manifestation of this tumor. The case is a 27 year old lady with pain in thumb, index and middle finger which exacerbated at night. Pain was constant, progressive with exacerbation at night that awakes the patient at 3- 4 A.M. The patient's symptoms did not relieve after carpal tunnel decompression. Due to refractory pain, the patient was dependent on analgesics. There was pain on wrist motion when she was examined. The Phalen test was positive, but Tinel test was negative. Electrodiagnostic study showed decrease median nerve conduction velocity. Radiographic study showed tumor and C.T scan documented it. This is the first case of osteoid osteoma with carpal tunnel syndrome. It seems that radiography in patients with refractory carpal tunnel syndrome is necessary