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Chapter 63

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1. Avulsive cortical irregularity

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Figure 63-1

Avulsive cortical irregularity.

A. There is a faint oval lucency (arrow) in the medial aspect of the distal femoral metaphysis of an 8-year-old boy. A peripheral sclerotic rim is present. B, C. The cortical lesion in this 9-year-old girl is smaller and has minimal adjacent sclerosis. The lateral view confirms the typical posterior location and shallow character.

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2. Fibrous cortical defect

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Figure 63-2

Fibrous cortical defect.

There is a shallow oval lucency in the distal femoral cortex. The margins are well-defined and slightly sclerotic.

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3. Nonossifying fibroma

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Figure 63-3

Nonossifying fibroma.

A-C. Examples of nonossifying fibromas in 3 different children. The lesions in (A) and (B) have the typical multiloculated character, with thin sclerotic margins and cortical thinning. The lesion in (C) is oval and slightly expansile. All 3 project much deeper into the medullary cavity than would occur with a fibrous cortical defect.

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4. Nonossifying fibroma

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Figure 63-4

Nonossifying fibroma.

A, B. Coronal and axial CT images of a 17-year-old boy show the cortical origin of the lesion and medullary extension. The overlying cortex is thinned and slightly expanded. A thin sclerotic margin is present centrally. The matrix has similar attenuation as muscle.

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5. Nonossifying fibroma

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Figure 63-5

Nonossifying fibroma.

A. The matrix (arrow) is approximately isointense to adjacent skeletal muscle. The sclerotic wall is hypointense. B. The lesion is hyperintense on a STIR sequence. C. The lesion (arrow) has a slightly heterogeneous character on this spin echo (SE) T2-weighted image, and is hypointense relative to marrow.

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6. Nonossifying fibroma

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Figure 63-6

Nonossifying fibroma.

A. A nonossifying fibroma of the fibula of a 9-year-old girl is hypointense to muscle on this T2-weighted image. B. The matrix undergoes mild, slightly heterogeneous enhancement with IV gadolinium.

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7. Nonossifying fibroma

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Figure 63-7

Nonossifying fibroma.

A, B. This large multiloculated ...

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