A painful hip in a young adult may have its origin in different aetiologies, and both clinical history and physical examination are crucial for diagnostic guidance. The authors describe the case of a 28 year-old male, amateur football player, suffering from insidious progressive left cruralgia, with nocturnal and prolonged high-impact loading activities exacerbation, resulting in significant impairment of exercise tolerance, gait and other daily activities. He had a transitory response to non-steroid anti-inflammatory drugs. Besides slight limitation of hip internal rotation and an antalgic gait pattern, physical examination was normal. Laboratory tests and conventional X-ray of the left hip were normal. CT and MRI depicted findings compatible with an osteoid osteoma in the femoral cervico-cephalic transition and signs of a potential «cam» type femoro-acetabular impingement. The adopted therapeutic strategy consisted on radiofrequency excision of the nidus of osteoid, with complete clinical recovery after 6 months.