What is the diagnosis for a patient with a sclerotic lesion on CXR with a central nidus of lucency?

A sclerotic lesion on a chest X-ray (CXR) that also presents with a central nidus of lucency is characteristic of an osteoid osteoma. This benign bone tumor typically appears as a small, well-defined sclerotic area surrounding a central lucent nidus. The central nidus is usually less dense than the surrounding sclerotic bone, which is why this presentation is distinctive.

Osteoid osteomas are often associated with pain that is relieved by nonsteroidal anti-inflammatory drugs (NSAIDs), which also highlights the condition's unique nature. The primary location for osteoid osteomas is in cortical bone, particularly in the femur and tibia, but they can occasionally be found in other areas, including the chest.

The other diagnoses do not align with the described imaging characteristics. Osteosarcoma typically presents as a more aggressive, lytic lesion with an ill-defined margin, and it is associated with a periosteal reaction rather than a well-defined nidus. Osteochondromas usually present as an outgrowth of bone with a cartilage cap and do not exhibit the same sclerotic and lucent characteristics central to osteoid osteoma. Ewing sarcoma often appears as a destructive bone lesion with