Fibrous dysplasia - tibia

120 views525y Male10/9/2026

Clinical Presentation

This young man recalled a history of trauma. He presented with pain and swelling in the left lower leg.

1A lytic lesion is demonstrated in the left lower tibial diaphysis with ground-glass appearance, endosteal thinning of the cortex, and some ballooning of the shaft
2No periosteal reaction is seen
3Three phase dynamic bone scintigram (only delayed images shown here) demonstrates a hot spot in the left tibia caused by increased uptake of the radioisotope tracer technetium-99m methylene diphosphonate (99m Tc MDP)
4The increased uptake is already visible in the early phase
5Magnetic resonance imaging (MRI) shows typical features with a low-to-intermediate signal intensity equal to that of muscle on T1-weighted images in the tibial shaft, with endosteal thinning of the cortex and no periosteal or surrounding soft-tissue changes
6T2-weighted images also show low signal intensity owing to the high content of collagen and bone
7A mild and homogeneous enhancement pattern of the lesion is seen after gadolinium
8Distribution of monostotic fibrous dysplasia
9Layout and distribution: Frank Gaillard 2012, Line drawing of skeleton: Patrick Lynch 2006, Creative Common NC-SA-BY