Which of the following is a differential diagnosis for Wilkinson syndrome?

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When evaluating Wilkinson syndrome, clinicians consider conditions that can mimic its focal bone lesion on imaging and its symptom pattern. Osteoid osteoma stands out as a differential because it is a small, localized bone lesion that often causes persistent, localized bone pain, frequently worse at night, and typically shows a nidus with surrounding sclerosis on imaging. This combination of a tiny, well-defined lesion and characteristic pain helps it resemble Wilkinson syndrome on radiographs and clinical presentation, making it a key alternative diagnosis to consider.

Other options tend to have different profiles: osteoarthritis usually affects older patients with joint space narrowing and osteophytes rather than a small focal nidus; osteomyelitis often presents with systemic signs of infection and more diffuse bone and soft-tissue involvement; osteosarcoma typically shows aggressive bone destruction with periosteal reaction and a soft-tissue mass.