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Osteoid osteoma, which is a benign bone-forming tumor. It is typically seen in older children and adolescents and exhibits a male predominance (male-to-female ratio, 2:1). Most children complain of localized pain, usually in the femur and tibia; however, arms and vertebrae may also be involved. Radiographs and computed tomography scans demonstrate an osteolytic area surrounded by densely sclerotic reactive bone, and bone scans reveal "hot spots." The site is usually <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. Treatment is surgical excision.