Case: 

We report the case of a 15-year-old male patient presenting with persistent wrist pain after surgical treatment of a triquetral osteoid osteoma. The patient was found to have a persistent nidus. These tumors are difficult to observe intraoperatively or through fluoroscopy, limiting adequate resection and resulting in continued pain.

Conclusion: 

The nidus was excised successfully through an unusual technique using tetracycline for intraoperative identification. The patient remains asymptomatic without recurrence at 31 months postoperative. Difficulties visualizing and removing carpal lesions leading to recurrence are described.