Presentation
Patient reported a history of bone lesions in his femur when presenting to ED with pain in the right leg post minor trauma.
Patient Data
On the lateral distal right femur, there is a cortical based sclerotic lesion with a well defined margin and no aggressive features. On an x-ray that the patient had printed out from 2 years earlier this same lesion was seen to be more lucent with features of a fibrous cortical defect. Given the previous images the findings were now consistent with a healed fibrous cortical defect.
In addition, there is an irregular cortical lesion on the distal medial femoral metaphysis.. The location and radiographic features, are most suggestive of a cortical desmoid.
Case Discussion
On the lateral aspect of the distal right femur in a cortically-based position, there is a sclerotic lesion with a well defined margin and no aggressive features. On an x-ray that the patient had printed out from 2 years earlier this same lesion was seen to be more lucent with features of a fibrous cortical defect. Given the previous images the findings were now consistent with a healed fibrous cortical defect.
A irregular bone lesion at the cortex of the medial femoral condyle was also noted. The position and features of this lesion were in keeping with a tug lesion, a cortical desmoid tumor.