Fibrous cortical defect

Case contributed by Mostafa Elfeky
Diagnosis almost certain

Presentation

Pain around left knee

Patient Data

Age: 16 years
Gender: Female
x-ray

A cortical-based eccentric metadiaphyseal lucent lesion with a sclerotic rim is seen at the posteromedial aspect of the lower left femur. It shows overlying focal cortical thinning.

Case Discussion

Plain film features are characteristic of a fibrous cortical defect. It is a benign bony lesion that is usually small in size, occurs in skeletally immature children between age 2-15 years, and usually asymptomatic. It is typically seen in the distal femur, proximal and distal tibia. 

It is one of the skeletal “Don’t touch” lesions. Lesions larger than 2 cm are called non-ossifying fibromas

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