Fibrous dysplasia

Case contributed by Ian Bickle


Bowel obstruction?

Patient Data

Age: 75 years
Gender: Male

No bone obstruction.

Mixed lucent sclerotic expansile lesion in the left femoral neck.

Bone expansile lesion in the left ilium.

Femur imaging from several years prior identified


Mixed sclerotic-lucent expansile lesion in the left femoral neck and proximal diaphysis.  An early shepherd's crook has developed.

Case Discussion

Fibrous dysplasia incidentally identified on a plain abdominal radiograph.   This was clarified and the extent elucidated on dedicated hip radiographs.

Fibrous dysplasia is the most classical and commonest condition associated with a shepherd's crook deformity.

This would make a suitable FRCR viva case.    

-  film edge abnormality on the abdominal film

- suggest dedicated images or review of the patient's prior imaging

- ability to assess a candidate's approach to a focal bone abnormality

- observe if the candidate recognizes a shepherds crook deformity

- explore the candidate's knowledge of a shepherd's crook deformity such as the conditions associate with this sign.

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