Normal femoral ossification

Case contributed by Jeremy Jones
Diagnosis certain

Presentation

Fall 3 weeks ago from scooter directly onto flexed knee. Pain and restriction of movement.

Patient Data

Age: 9 years
Gender: Female
mri

On the PD sagittal sequence, there is an ovoid region of low SI in the subchondral marrow of the posterior portion of the lateral femoral condyle. Appearances are of normal ossification; this is not an osteochondral defect.

Case Discussion

The variation in appearance of normal ossification in the posterior portion of the femoral condyles is broad. It is not uncommon to see this type of subchondral signal abnormality misdiagnosed as an osteochondral defect / osteochondritis lesion.

Features that make normal ossification more likely: location, normal overlying cartillage, no edema, geographic or puzzle piece morphology.

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