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While typical patterns of osteoid osteoma have been described on CT, MRI findings can overlap among different diseases, and atypical patterns exist. In this study, we assessed the presence of a novel dark rim sign and its utility in the MRI diagnosis of osteoid osteoma. The purpose of this retrospective study was to assess the utility of the dark rim sign seen on MRI in children with osteoid osteoma. MRI studies from 36 pediatric patients with osteoid osteoma and a control group of patients with either osteomyelitis or stress fracture w