Musculoskeletal ImagingFibrous cortical defect
a
benign bone
tumour related to
nonossifying fibroma, composed of whorled bundles of connective tissue cells. Fibrous cortical defect, although frequently considered synonymous with nonossifying fibroma, tends to be a smaller and asymptomatic bone
lesion. The
tumour may result from an unrecognized local
trauma to the periosteum. However, small cortical fibrous lesions are seen regularly on normal radiographs of healthy children; their absence in children under the age of 2 years suggests the possibility of muscle pull during walking and weight-bearing as a cause.
The tibia and femur are affected most frequently, especially in the metaphysis close to the physeal plate. Fibrous cortical defects usually arise from the posterior wall of the tubular bone and involve the medial bone surface.
Radiographically, the lesions appear as shallow oval or circular radiolucent cortical areas, sometimes with a blister-like shell, surrounded by normal or sclerotic bone. Usually plain radiographs are adequate for diagnosis (Fig.1).
DR/RB
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Oblique radiograph of the ankle demonstrates an eccentric, cortically based bubbly lesion in the distal tibial metadiaphysis.
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Fibrous cortical defect, Fig.1 | |