Indian Journal of Radiology and Imaging Indian Journal of Radiology and Imaging

QUIZ
Year
: 2006  |  Volume : 16  |  Issue : 4  |  Page : 925--926

Radiological quiz - musculoskeletal


NU Bahri, HP Parekh, SL Chudasama, HH Zalawadia, PV Padhara, N Mittal 
 Kailash", 35-B, Janata Society, Kamdar Main Road, Jamnagar- 361006, Gujarat, India

Correspondence Address:
H H Zalawadia
Kailash«DQ», 35-B, Janata Society, Kamdar Main Road, Jamnagar- 361006, Gujarat
India




How to cite this article:
Bahri N U, Parekh H P, Chudasama S L, Zalawadia H H, Padhara P V, Mittal N. Radiological quiz - musculoskeletal.Indian J Radiol Imaging 2006;16:925-926


How to cite this URL:
Bahri N U, Parekh H P, Chudasama S L, Zalawadia H H, Padhara P V, Mittal N. Radiological quiz - musculoskeletal. Indian J Radiol Imaging [serial online] 2006 [cited 2020 Aug 14 ];16:925-926
Available from: http://www.ijri.org/text.asp?2006/16/4/925/32386


Full Text

A 17 year old girl presented with bowing of left leg and NO complaint of pain. Past history of fracture of tibia of same side before 7 years. Roentgenogram [Figure 1] was taken and then computed tomography [Figure 2],[Figure 3] was done with 5mm contiguous axial scans. What is your diagnosis?

 Radiological Diagnosis



 View AnswerOSSIFYING FIBROMA

Ossifying Fibroma of the tubular bones are rare, being first reported by 'Kempson' in 1966 [1],[2]. Predominant involvement of tibia and to a lesser extent fibula has been emphasized in all the reports. Rare sites of Ossifying Fibroma are the ulna, radius, humerus, metatarsals & phalangeal bones [3],[4]. Diaphyseal location is typical, especially middle third of tibia although some may extend into the metaphysis. Involvement of distal diaphyseal segment of fibula is also characteristic. In tibia the lesion is usually located in anterior aspect of bone, apparently banging as intracortical tumour and subsequently involves spongiosa. More than one bone may be involve simultaneously or metachronously [3],[5].

Ossifying Fibroma of tubular bones generally seen in first or second decade of life, with the boys & girls affected with equal frequency with the painless enlargement bowing of bones. [6]

In the tibia slight or moderate anterior or anterolateral bowing is the rule. Intracortical osteolysis clearly marginated by a band of sclerosis may be seen as a single confluent lesion or multiple elongated bubble like areas [7]. The tumour itself-varies from 1 to 10 cm. In its maximum dimension, on section the tumour is found to be located eccentrically and to bulge from the cortex into the medullary cavity, but rarely extend to involve the complete circumference of the bone. In the fibula however, the entire width of the bone is involved. The tumour appears well demarcated from adjacent uninvolved bone by thin band of sclerosis [8].

The radiological feature of Ossifying Fibroma in the tubular bones most resembles those of the fibrous dysplasia but the monostotic fibrous dysplasia commonly affects patients in second and third decade of life and in addition to the tibia, frequently involves the rib, femur, facial bones or skull [8]. The major point of difference between ossifying fibroma and fibrous dysplasia, histologically is the lack of osteoblastic rimming on the metaplastic trabecula in the fibrous dysplasia [1].

References

1Kempson RL: Ossifying fibroma of the long bones. A light and electron microscopic study. Arch Pathol 82:218, 1996.
2Alguacil-Garcia A, Alonso A, Pettigrew NM: Osteofibrous dysplasis (ossifying fibroma) of the tibia and fibula and adamantinoma. A case report. Am J Clin Pathol 82:470,1984
3Campanacci M: Osteofibrous dysplasis of long bones. A new clinical entity. Ital J Orthop Traumatol 2:221,1976
4Goergen TG. Dickman PS, Resnick D, et al: Long bone ossifying fibroma. Cancer 39:2067, 1977.
5Capusten BM, Rochon L, Rosman MA, et al: Osteofibrous dysplasia. J Can Assoc Radiol 31:50, 1980.
6Anderson MJ, Townsed DR. Johnston JO, et al: Osteofibrous dysplasia in the newborn. Report of a case. J Bone Joint Surg (am) 75:265, 1993.
7Campanacci M, Laus M: Osteofibrous dysplasia of the tibia and fibula. J Bone Joint Surg (Am) 63:367,1977
8Resnick D, Kyriakos M, Greenway G. Tumors and tumor like lesions of bone: Imaging and Pathology of specific lesions. In : Resnick D. Diagnosis of bone and joint disorders, 3rd ed. Philadelphia : W.B.Saunders. 1995 : 3668-72