Osteoid osteoma is the third most common benign bone tumor. It is often seen in metaphysis and diaphysis of long bones especially femur and tibia. Osteoid osteoma is very rare in hand, thumb, and distal phalanx. In this report we present a 14-year-old patient suffering from painful swelling in the distal phalanx of thumb and clubbing. Radiography showed lucent's lesion with sclerotic margin. Laboratory findings were normal. There was no evidence confirming infection. After excision of the lesion, osteoid osteoma was confirmed based on pathological findings. One month after excision, the patient`s pain was completely resolved.  Based on this report, osteoid osteoma is one of the reasons for local painful swelling and finger clubbing. This is one of the main differential diagnoses of painful finger swelling which should always be considered. Surgical excision and lesion curettage are efficient methods in the treatment of phalangeal osteoid osteoma.

Keywords: Thumb, Hand, Osteoid osteoma

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