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    Go to the top of the page   ID: 20020815173954 Original case in english  More links about this topic on Pubmed (PubMed Reader)
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    Fibrous cortical defect
    H Frimmel. Fibrous cortical defect. PedRad [serial online] vol 2, no. 8.
    URL: www.PedRad.info/?search=20020815173954


    ( There are questions in the CMK-Mode for this topic )

     
     Pediatric Radiology CasesImages to this case: There are X-Ray-images available for this case. [ X-Ray ] There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    H. Frimmel (Halle)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    14 Years  

     
     Pediatric Radiology CasesGender:

    Female  

     
     Pediatric Radiology CasesRegion-Organ:

    Leg-Bones  

     
     Pediatric Radiology CasesMost likely etiology:

    other  

     
     Pediatric Radiology CasesHistory:

    14 year-old girl. Findings following a fibular fracture of the right talocrural joint in 01/2002. Thereby a chance finding of a "cystic finding" in the right distal tibia. Scintigraphy in 03/2002: no increased uptake, only slight photopenic area. Follow-up: Scintigraphy in 07/2002: marginally increased bone metabolism, possible tumor, therefore now sent to us for an MRI.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    Synonym: fibrous metaphyseal defect.
    Developmental disturbance in the metaphyseal region of the long bones, to 90% in the lower extremity.
    Defect with fibrous connective tissue with connection to the overlying periosteum.
    Classical "tumor-like" lesion.
    Is, when spanned over 4 cm, categorized as a "Non-ossifying fibroma"  

     
     Pediatric Radiology CasesRadiological findings:


    X-Ray 1 <- view X-Ray 1

    X-ray 1: Sclerosed edges, cystic-looking defect in the corticalis.












    MRI 1 <- view MRI 1

    MRI 1: coronal T2-weighted image with fat saturation: Centrally, the mass is very low in signals without circumscribing edema. (Other findings: edema in the distal fibula following fracture)












    MRI 2 <- view MRI 2

    MRI 2: transversal T2-weighted image with fat saturation: In the corticalis of the tibia, there is a mass very low in signals without circumscribing edema.






    MRI 3 <- view MRI 3

    MRI 3: T1-weighted image, transversal: Excentric-lying lesion in the distal metaphysis of the right tibia, expansion: 3 cm, well-demarcated.






    MRI 4 <- view MRI 4

    MRI 4: T1-weighted image, transversal, with fat saturation after contrast: Excentric-lying lesion in the distal metaphysis of the right tibia, expansion: 3 cm, well-demarcated. No contrast uptake, some, discrete contrast uptake on the edges.



     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    Total constellation (Consens)  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    In this case, no further diagnostic tests were needed after x-ray.

    After stating the suspicion of a tumor after scintigraphy, an MRI was needed.

    In general, the MRI does not give us further information about fibrous cortical defects that would help us in the diagnosis. In this case, the signal weakness of the fibrous material lead us to our goal.

    In very large non-ossifying fibromas, the differential diagnosis could be juvenile or aneurysmatic bone cyst (proof of fluid in MRI).

    Benign fibrous histiocytoma (age of the patient, pain).  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    No symptoms. Often x-ray chance findings in the 1st and 2nd decade of life.
    Very rarely spontaneous fractures.
    Usually disappears in further bone development by the age of 18.  

     
     Pediatric Radiology CasesComments of the author about the case:

    Overall, conventional x-ray with the "classic findings":]
    - sharply bordered, solitary radiolucency, parallel to the corticalis, located excentric in the metaphysis of the long bones (mostly lower extremity). It is divided from the healthy bone by a sclerosis band. In conjunction with the patient's history and clinical signs (age, missing symptoms), it is usually enough to make the diagnosis.

    The MRI was performed due to the not quite clear findings in the scintigraphy.  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    1. Medline: Medline
    K. Bohndorf, H. Imhof
    "Radiologische Diagnostik der Knochen und Gelenke"
    Georg-Thieme-Verlag 1998  

     
     Pediatric Radiology CasesKeywords:

    fibrotic corticalis defect, fibrous cortical defect, fibrotic, corticalis defect, non-ossifying, fibroma, fibula, fibrous metaphyseal defect, non ossifying fibroma, child, childhood, pediatric radiology  

     
     Pediatric Radiology Cases Cite this article:

    H Frimmel. Fibrous cortical defect. PedRad [serial online] vol 2, no. 8.
    URL: www.PedRad.info/?search=20020815173954  

     
     Pediatric Radiology Cases Read similar articles: with corresponding keywords
    in the same field: Leg-Bones
    or in the region: Leg
    or in the tissue/organ: Bones
    or with the etiology: other
     
     Pediatric Radiology CasesImages to this case: There are X-Ray-images available for this case. [ X-Ray ] There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     
    Fibrous cortical defect
    H Frimmel. Fibrous cortical defect. PedRad [serial online] vol 2, no. 8.
    URL: www.PedRad.info/?search=20020815173954


    ( There are questions in the CMK-Mode for this topic )

     

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    Fibrous cortical defect
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    Search H. Frimmel in Medline H. Frimmel (7)   

    Fibrous cortical defect  
     
    Fibrous cortical defect
    H Frimmel. Fibrous cortical defect. PedRad [serial online] vol 2, no. 8.
    URL: www.PedRad.info/?search=20020815173954


    ( There are questions in the CMK-Mode for this topic )

     
     
    Fibrous cortical defect
    H Frimmel. Fibrous cortical defect. PedRad [serial online] vol 2, no. 8.
    URL: www.PedRad.info/?search=20020815173954


    ( There are questions in the CMK-Mode for this topic )

     

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    Fibrous cortical defect
    H Frimmel. Fibrous cortical defect. PedRad [serial online] vol 2, no. 8.
    URL: www.PedRad.info/?search=20020815173954


    ( There are questions in the CMK-Mode for this topic )

     




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