There is considerable bony destruction involving the lateral and posterolateral cortex through the diametaphyseal region with elevation of the periosteum and minor extension beyond the periosteum.
Post-contrast T1 images demonstrate enhancement which corresponds almost exactly with the area of high T2 signal. Through the central portion of the lesion there is an irregular large area of non enhancement which corresponds with heterogeneous T2 signal. This likely reflects a central necrotic portion of the lesion.
The extensive periosteal reaction and cortical changes at the lateral and posterolateral aspect of proximal diametaphyseal region is predominantly lamellated rather than sunburst in type.
This favours malignancy over infection given there is no extension of oedema beyond the areas of enhancement.