Nonossifying Fibroma with Pathologic Fracture - MSK Radiology Imaging Findings: • Cortically based, geographic, lucent lesion with a sclerotic peripheral margin measured > 3cm. • MRI demonstrates the cortically based lesion with T1- and T2-heterogenous signal with regions of hypointense signal representing fibrous/hemosiderin portions. The arrows delineate a nondisplaced linear fracture emanating from the lesion into the femoral metadiaphysis with surrounding marrow edema. Case description: • Nonossifying Fibroma and Fibrous Cortical Defects are histologically similar and sometimes differentiated based on size (NOF > 3cm). Both coined "Fibroxanthoma". • Do Not Touch lesions with no follow-up or biopsy necessary in almost all cases. Diagnose with X-RAY; usually resolve by age 20-25. • This case shows potential of pathologic fracture in athletes. • Multiple NOF's in NF-1 or Jaffe-Campanacci syndrome. Differential diagnosis for similar lesion: • Simple bone cyst: Central, "cyst-like" lesion on MRI without hypointense fibrous tissue. • Aneurysmal bone cyst: Eccentric expansile lesion, MRI shows fluid-fluid levels. Dr. Donald von Borstel @DrvonBorstel #Nonossifying #Fibroma #NOF #Fracture #clinical #mri #clinical #Radiology #diagnosis #msk
