KINDERRADIOLOGIE ONLINE - view radiology images and radiology cases
Lesen Sie diese Seite auf Deutsch   Read this page in English
The Peer Reviewed Pediatric Radiology Platform on the Web
ISSN: 1942-955X :: Publisher: EduRad ::Editor-In-Chief: Roland Talanow, MD, PhD  
Browse Browse || Search Search || Online Book Systematically Online Book Systematically || Discussion Forum Discussion Forum || News News || Submit a Case Submit a Case || Rules Rules |
Most Interesting Cases Most Interesting Cases || "Most Diligent" Authors "Most Diligent" Authors || Case of the Day Case of the Day || Teaching files Teaching files || Links Links |
Newsletter Newsletter || Start Start || Survey Survey || Your Opinion Your Opinion || My Profile My Profile || CME-Credits CME-Credits |
    Pediatric Radiology News / Ads / Jobs Get the Pediatric Radiology News as RSS feed !
    Send us your news or ads for free
  • CME Kurs: Paediatric Body MRI

  • CME course: Paediatric Body MRI

  • Universitätsklinikum Jena sucht eine Ärztin/einen Arzt in Weiterbildung in Vollzeit

  • Kinderspital Zürich sucht Oberärztin / Oberarzt (100 %)

  • Kinderradiologische Oberärztin / Oberarzt gesucht

  • 2 Stellen in der Kinderradiologie - 1 Assistenzärztin/Assistenzarzt und 1 Oberärztin/Oberarzt in Voll- oder Teilzeit

  • Senior Paediatric Radiologist in Pediatric Radiology section needed

  • Facharzt als Oberärztin / Oberarzt in Sektion Kinderradiologie gesucht

  • Stellenangebot für Assistenzarzt (m/w) zur Facharztausbildung für RADIOLOGIE und/oder KINDERRADIOLOGIE

  • „Fellow“-Stelle zur Weiterbildung in Pädiatrischer Radiologie am Kinderspital Zürich

  • Fellow-Stelle Pädiatrische Neuroradiologie

  • FFF Kinderradiologie - Muskuloskelettale Radiologie im Kindesalter (Fit für den Facharzt)

  • Assistenzarzt für Kinderradiologe gesucht an Universitätsklinikum Schleswig-Holstein, Campus Kiel

  • Turnusarzt (m/w) in Ausbildung zum Facharzt (m/w) für Radiologie

  • Assistenzarzt (m/w) zur Weiterbildung im Schwerpunkt Kinderradiologie

  • Send us your news or ads for free

    Get the Pediatric Radiology News as RSS feed !


    Radiolopolis

    The dynamic Radiology community for education, research and practice


     

    Case of the Day
    Fibrous cortical defect

    Modality: X-Ray Modality: MRI Modality: MRI Modality: MRI Modality: MRI

    View here all images of this case in different sizes !



    Go to the top of the page ID: 20020815173954
    | The authors | Discussion | Write comments about this Case |
    | Recommend this Case to a Colleague |
     Fibrous cortical defect   
     Available images: There are X-Ray images available for this case. [ X-Ray ] There are X-Ray images available for this case. [ MRI ]   
     Author/s:

    H. Frimmel (Halle)  

     
     Email Address:

    Viewable for logged on visitors (Log on)  

     
     Age:

    14 Years  

     
     Gender:

    Female  

     
     History:

    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.  

     
     Pathomorphology 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"  

     
     Radiological 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.

     

     
     Diagnosis confirmation:

    Total constellation (Consens)  

     
     Which 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).  

     
     Course / 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.  

     
     Comments 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.  

     
     First description / History:

    N/A  

     
     Literature:

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

     
     Region-Organ:

    Leg-Bones  

     
     Most likely etiology:

    other  

     
     Available images: There are X-Ray images available for this case. [ X-Ray ] There are X-Ray images available for this case. [ MRI ]   
    More cases from these authors: Search H. Frimmel in Medline H. Frimmel (7)     




    Discussion >> Write Comment <<



      There are no comments available regarding this case.





     Write a comment to this case (With * marked fields have to be filled)

    Type in this number: 5226

    Name: *

    E-Mail:

    Website:

    Subject: *

    Text: *




     
      Pediatric Radiology Discussion Get the Pediatric Radiology Discussion as RSS feed !
      To the discussion forum
      To the discussion forum

      Get the Pediatric Radiology Discussion as RSS feed !

      © 2001-2021   www.kinderradiologie-online.de
      In cooperation with © Radiolopolis - Radiology Search - Radiology Teacher - PubMed Reader - Annotate - Radiology Lectures & Tutorials - Radiology Boards Preparation - Pediatric Radiology Links - Pediatric Radiology Information - Emergency Radiology - Lung Cancers - USMLE Forums - Cancer Staging Information - Chest Radiology - Radiology Case Report Journal
      For suggestions and questions: information@kinderradiologie-online.de
      Add this site to your favorites (CTRL+D)