Discussion Author: Jacqueline M Bernard
Nonossifying fibroma is one of the most common bone lesion encountered by radiologists. The incidence varies from 20-40 % of children over the age of two. It is a benign, asymptomatic fibrous cortical defect that regresses with age. These are rarely seen after the age of 30.
These lesions are cortically based and occur in the metaphysis of a long bone. They may arise secondary to the epiphyseal plate and migrate away from the plate with growth. These lesions typically have a thin, sclerotic border that is scalloped and slightly expansile. It is radiographically non-aggressive. There is no associated periostitis. These lesion "heal" with sclerosis and eventually disappear. During this healing phase these lesions can appear hot on bone scans.
Occasionally these patients will present with a pathological fracture through the lesion. In these cases the periosteal reaction associated with a healing fracture can appear very aggressive.
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