Fact-sheet: Benign cortical defect


Updated on 10/04/2019 at 9:38 AM

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Definition

Also called cortical defect (< 2cm) or non-ossifying fibroma (> 2 cm)

  • Benign pseudotumor of connective tissue
  • 30-40% of children
  • 95% diagnosed before age 20, M>F
  • 80% in the lower limbs (distal femur, tibia)
  • Single (75%) or multiple (25%)
  • Course towards regression, ossification

Clinical features

  • Majority of cases are incidental findings, asymptomatic
  • Pathologic fracture if > 5 cm

Radiography

  • Lucent lesion surrounded by peripheral sclerosis
  • Metaphyseal location, eccentric, cortical
  • Long axis parallel to that of the diaphysis
  • Well-defined margin

CT

Not indicated if typical on radiography

  • Same features as on radiography
  • Cortical hypodensity surrounded by a dense peripheral rim
  • Metaphyseal location, eccentric
  • Long axis parallel to that of the diaphysis
  • Well-defined margin

MRI

Not indicated if typical on radiography

If performed, peripheral T1 and PD hyposignal related to the sclerosis, with intermediate central signal

Nuclear medicine

At the end of growth, possible uptake on bone scintigraphy if in the ossification phase

Management

"No touch lesion": no biopsy if typical