A 12-year-old girl presented with a 1-week history of left ankle swelling and pain following an ankle inversion injury. There was tenderness and swelling over the left lateral malleolus. Plain radiographs showed a lytic expansile lesion over the distal fibula with onion-skin lamellar periosteal reaction, a wide zone of transition and cortical erosion (Fig. 1). MRI showed a 9.5 × 3.1 × 5.1 cm mass with heterogeneous contrast enhancement with cortical erosion (Fig. 2). Histology obtained via incisional biopsy yielded Ewing’s sarcoma with EWSR1-ERG gene fusion. PET-CT showed no systemic metastases. She underwent neoadjuvant chemotherapy, followed by wide resection and reconstruction and finally adjuvant chemotherapy.