Case contributed by Dr Jeremy Jones


Knee injury while playing football. Restriction of movement and anterior tibial tenderness.

Patient Data

Age: 15
Gender: Male

Tibial lesion of the proximal anterior cortex. Predominantly narrow zone of transition. Mixed lucent (cranial) and more sclerotic (caudal). No periosteal reaction. Appearances are indeterminate with some aggressive and some non-aggressive features. Further imaging required. Will likely require biopsy.


The lesion demonstrated on the plain film is T1 hypointense, T2/STIR hyperintense and enhances following contrast. There is accompanying diffusion restriction. No periosteal reaction or soft tissue mass. The lesion is solid, lytic with features of an aggressive lesion, but no periosteal reaction. In this location, the most likely diagnosis is adamantinoma.

Case Discussion

The lesion is solid, lytic with diffusion restriction. There is no cystic component. In this location, an aggressive cortical tumor is most likely to be an adamantinoma, and this was proven at biopsy.

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Case information

rID: 26852
Published: 13th Sep 2018
Last edited: 13th Sep 2018
Inclusion in quiz mode: Included

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