Non-ossifying fibroma (NOF)

Case contributed by Frank Gaillard
Diagnosis certain


Sprained ankle playing sport.

Patient Data

Age: 14 years
Gender: Male

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:

  1. non-ossifying fibroma (>2 cm)

  2. fibrous cortical defect (<2 cm)

Both are pathologically identical.

Non-ossifying fibromas have the following features (all shown here):

  1. present in adolescents and young adults

  2. commonest location is the femur and tibia

  3. dia-metaphyseal in location

  4. eccentric with mild expansion

  5. well defined lucent lesion with a sclerotic margin

  6. cortical thinning, but not breach

Lesions are asymptomatic and are usually an incidental finding. Lesions often spontaneously regress.

Case courtesy of Dr. Ian Bickle.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.