Shepherd crook deformity - polyostotic fibrous dysplasia

Case contributed by Dr Ian Bickle

Presentation

Longstanding shortening of the left leg. Fall. Fracture?

Patient Data

Age: 75 years
Gender: Female

Shepherd crook deformity of the left hip as evidenced by a severe coxa varus angulation of the proximal femur.  Underlying lucent expansile lesion in the femoral neck and proximal femoral diaphysis

Previous study from several years ago

Nuclear medicine

Multiple foci of increased tracers uptake in the long bones of the peripheral skeleton, left hip and pelvis. This is most pronounced and multifocal in the right tibia.

Shepherd crook deformity of the left hip.

Case Discussion

This is a case of polyostotic fibrous dysplasia.  The most frequent sites of involvement are the femur, tibia and pelvis.  This is giving rise to the classic shepherd crook deformity in the left hip.

Case submitted in conjunction with Dr Suman Bandhu.

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