Citation: Georgiev GP, Slavchev SA, Dimitrova IN. Osteoid osteoma of the middle phalanx of the third fi nger in a child mimicking a malignancy. Folia Med (Plovdiv) 2018;60(2): 314-7.Osteoid osteoma is a rare occurrence in the hand, especially in children. We report here a rare case of a 12-year-old boy complaining of growing painful swelling of the middle phalanx of the third fi nger that had started 3 months earlier and had not responded to anti-infl ammatory medication. Based on the clinical fi ndings and plain radiographs, osteomyelitis or Ewing's sarcoma was suspected. However, MRI revealed the typical characteristics of osteoid osteoma. The lesion was excised, and the histological examination confi rmed the diagnosis. We make a brief review of the literature concerning this uncommon localization and discuss the diff erential diagnosis and treatment modalities.