Presentation
Sprained ankle playing sport.
Patient Data
Age: 14 years
Gender: Male
From the case:
Non-ossifying fibroma (NOF)
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Ankle x-ray demonstrates a well circumscribed lucency in the distal diaphysis/metaphysis of the tibia. The margins are slightly sclerotic. No periosteal reaction is present. It does not abut the growth plate.
Case Discussion
Fibroxanthomas can be divided into:
- Non-ossifying fibroma (>2 cm)
- Fibrous cortical defect (<2 cm)
Both are pathologically identical.
Non-ossifying fibromas have the following features (all shown here):
- present in adolescents and young adults
- commonest location is the femur and tibia
- dia-metaphyseal in location
- eccentric with mild expansion
- well defined lucent lesion with a sclerotic margin
- cortical thinning, but not breach.
Lesions are asymptomatic and are usually an incidental finding. Lesions often spontaneously regress.
Case courtesy of Dr Ian Bickle
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