Bilateral cortical desmoid

Case contributed by Aravinda Perera
Diagnosis almost certain

Presentation

Bilateral genu varum, external tibial torsion and femoral anteversion undergoing surveillance x-rays with long leg views. Mild knee pain with overuse.

Patient Data

Age: 13 years
Gender: Male
x-ray

Slight bilateral genu varum with mechanical axis passing through medial tibial eminence on the right and medial aspect of medial tibial condyle on the left. Hip and ankle joint alignment appear unremarkable.

Small focal lucency is projected on the medial aspect of the distal femoral diametaphysis bilaterally. On this single projection they display a benign appearance thought to be of no clinical significance.

No concerning focal bony abnormality.

Case Discussion

The finding of bilateral distal femur saucer-shaped radiolucencies in combination with the patient's demographic profile is highly suggestive of cortical desmoid lesions. No further workup or treatment for these lesions was required.

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