1. Avulsive cortical irregularity
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.
2. Fibrous cortical defect
Fibrous cortical defect.
There is a shallow oval lucency in the distal femoral cortex. The margins are well-defined and slightly sclerotic.
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.
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.
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.
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.
A, B. This large multiloculated ...
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