Chronic dorsal pain revealing an osteoblastoma with costo-vertebral extension: A case report and literature review

Dorsal osteoblastoma is a rare benign bone tumor whose clinical ambiguity frequently delays diagnosis. Through this case report of a 33-year-old woman presenting with progressive lower-limb neurological deficits, we illustrate how a structured multimodal imaging approach — combining radiography, CT, and mainly MRI — enabled timely diagnosis and guided successful surgical management. Beyond describing the imaging findings, this report argues that the real clinical challenge lies not in identifying osteoblastoma once suspected, but in suspecting it in the first place. We discuss how awareness of its atypical presentations, including costovertebral extension, can prevent diagnostic error and therapeutic delay.