Non-ossifying fibroma: distal femur

Case contributed by Dr Angela Byrne

Presentation

Pain of the distal femur.

Patient Data

Age: 11 years
Gender: Female

Distal femur x-rays

Modality: X-ray

X-rays of the distal femur demonstrate an expansile lucent lesion with a thin zone of transition and no internal mineralisation. There is no periosteal reaction or evidence of cortical breach or soft tissue mass. It is approximately 3cm proximal to the growth plate, which remains open. 

CT

Modality: CT

Two selected axial CT images through the lesion confirms the plain film appearance, and demonstrates no evidence of an extra-osseous mass. 

MRI

Modality: MRI

MRI demonstrates an eccentric lesion composed of soft tissue with low T1 and T2 signal, which enhances following contrast administration. No fluid fluid levels, no surrounding oedema or enhancement and no extra-osseous abnormality. 

Distribution of NOF and FCD

Modality: Diagram

Distribution of non-ossifying fibromas (NOF) and fibrous cortical defects (FCD). Layout and distribution: Frank Gaillard 2009, Line drawing of skeleton: Patrick Lynch 2006, Creative Common NC-SA-BY

Case Discussion

This case demonstrates features consistent with a non-ossifying fibroma, confirmed histologically, and high-lights the benefits in multi-modality imaging in assessing such lesions. 

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Case Information

rID: 8111
Case created: 13th Jan 2010
Last edited: 27th Sep 2016
Tags: knee, femur
Inclusion in quiz mode: Included

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