Introduction: Proximal femur is the common site for localization of benign bone lesions, and the diagnosis is often delayed and potentially challenging due to their atypical presentations. Early diagnosis is difficult as intra-articular lesions often present with clinical and radiological features of inflammatory synovitis in the joint.
Case report: Two patients of intra-articular osteoid osteoma in proximal femoral presented with atypical features limb lengthening, minimal reactive bone sclerosis, and multifocal nidus. They were managed with anterior open approach, en bloc resection of the lesion, placement of autologous cortical graft, and prophylactic fixation with dynamic hip screw.
Conclusion: Intra-articular osteoid osteomas in proximal femoral neck present differently, making the diagnosis and treatment challenging. Anterior open approach, en bloc resection of the lesion, reinforcement, and prophylactic fixation with dynamic hip screw is a reasonable option for managing these lesions which can be easily done in an average clinical setup.
Keywords: Excision; Osteoid osteoma; Proximal femur.