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Osteoid osteoma is a painful, benign and common bone tumor that is prevalent in young adults. The typical clinical presentation consists of pain that becomes worse at night and is relieved by nonsteroidal anti-inflammatory drugs. The most common imaging finding is a lytic lesion, known as a nidus, with variable intralesional mineralization, accompanied by bone sclerosis, cortical thickening and surrounding bone marrow edema, as well as marked enhancement with intravenous contrast injection. When the lesion is located in typical locations (intracortical bone and the diaphyses of long bones), both characteristic clinical and radiological features are diagnostic. However, osteoid osteoma is a multifaceted pathology that can have unusual presentations, such as intraarticular osteoid osteoma, epiphyseal location, lesions at the extremities and multicentric nidi, and frequently present atypical clinical and radiological manifestations. In addition, many conditions may mimic osteoid osteoma and vice versa, leading to misdiagnosis. Therefore, it is essential to understand these musculoskeletal diseases and their imaging findings to increase diagnostic accuracy, enable early treatment and prevent poor prognosis.

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Objective: To analyze the most common methods for measuring patellar height and the impact of observer experience in correlations with the other observers using digital radiography. Methods: Sixty digital radiographs of the knee in lateral view were analyzed by four observers: a physician in the second year of medical residence in orthopedics (R2); a physician in the third year of medical residence in orthopedics (R3); an orthopedic surgeon who was a specialist in knee surgery (SK); and a radiologist who was a specialist in musculoskeletal radiology (SR). The indices used were: Insall-Salvati (IS), Blackburne-Peel (BP), Caton-Deschamps (CD) and modified Insall-Salvati (ISM). The interobserver agreement was calculated using the kappa coefficient (κ). Results: The highest correlation coefficients were found when using the IS method followed by the CD method. The worst correlation was observed in the ISM method. The highest interobserver agreement was found between the orthopedic surgeon specializing in knee surgery and the radiologist specializing in musculoskeletal radiology, for the four measurement methods used. Conclusion: Using digital radiography, the Insall-Salvati and Caton-Deschamps indexes presented the highest interobserver agreement, and this was also positively influenced by the observer's level of experience.