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Chondromyxoid fibroma

Case contributed by Dr Hani Salam

Presentation:

Knee pain and swelling.

Patient Data:

Age: 25 years

X-rays of the knee

Modality: X-ray

X-rays of the right keen demonstrate an expansile lesion of the proximal tibia with sharp zones of transition and expansion. It reaches the articular surface without breach of the cortex here or elsewhere. No matrix calcification or soft tissue component. 

MRI

Modality: MRI

MRI demonstrates the lesion to have very high T2 signal, low T1 signal with diffuse somewhat heterogeneous contrast enhancement. There is no surrounding oedema (not in bone nor in the adjacent soft tissues). 

Distribution of chondromyxoid fibromas

Modality: Diagram

Bone scan

Modality: Nuclear medicine

Bone scan demonstrates thin peripheral increased activity. It is an isolated abnormality. 

Case Discussion:

This is an advanced case of a benign chondromyxoid fibroma. Smaller lesions are typically located in the cortex of long bones. Tibia and foot are most commonly affected. The lesion is never purely epiphyseal, but may extend into the subchondral bone.

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