Spinal lesions can cause painful scoliosis, although this is less common with osteoblastoma than with osteoid osteoma.

In addition, lesions may mechanically interfere with the spinal cord or nerve roots, producing neurologic deficits.

[4] When diagnosing osteoblastoma, the preliminary radiologic workup should consist of radiography of the site of the patient's pain.

However, computed tomography (CT) is often necessary to support clinical and plain radiographic findings suggestive of osteoblastoma and to better define the margins of the lesion for potential surgery.

CT scans are best used for the further characterization of the lesion with regard to the presence of a nidus and matrix mineralization.

Metastases and even death have been reported with the controversial aggressive variant, which can behave in a fashion similar to that of osteosarcoma.

The tumors usually involve the posterior elements, and 17% of spinal osteoblastomas are found in the sacrum.

The long tubular bones are another common site of involvement, with a lower extremity preponderance.

Osteoblastoma of the long tubular bones is often diaphyseal, and fewer are located in the metaphysis.