Osteochondroma and non ossifying fibroma

Case contributed by Ali Abougazia
Diagnosis almost certain

Presentation

Left lower thigh pain. History of rheumatic fever.

Patient Data

Age: 13 years
Gender: Male

Rather well-defined sessile bony out-growth is seen at the lateral aspect of the lower third left femur. It shows continuity with the cortex and medullary cavity of the parent bone. There are overlying soft tissue edema and inflammatory changes which appear bright in T2 and of low signal in T1.

There is also another bony lesion in the posterolateral aspect of the left femur lower third at the same level of the bony out growth projection, having bubbly appearance and showing low signal in all sequences, sclerotic margin as well as narrow transitional zone .

Rather well-defined sessile bony out-growth is seen at the lateral aspect of the lower third left femur. It shows continuity with the cortex and medullary cavity of the parent bone. There are overlying soft tissue edema and inflammatory changes which appear bright in T2 and of low signal in T1.

There is also another bony lesion in the posterolateral aspect of the left femur lower third at the same level of the bony out growth projection, having bubbly appearance and showing low signal in all sequences, sclerotic margin as well as narrow transitional zone .

Case Discussion

Left femur lower third lateral osteochondroma (exostosis) with overlying soft tissue edema and inflammatory changes, and posterolateral non ossifying fibroma.

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