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Age / Sex : 7 / F
Age/Sex: 7/F
C.C.: intermittent knee pain for 3 months
1) What is your impression?
Courtesy : Sang Yong Lee, MD., Chonbuk National University College of Medicine
Diagnosis: periosteal desmoid (juxtacortical desmoid)
Discussion
* Synonnym : juxtacortical desmoid, cortical desmoid, abulsive cortical irregularity, distal femoral cortical excavation
Findings:
- Oval shaped radiolucent cystic lesion in distal femur, posterolateral cortex
- Area of cortical osteolysis in distal femur, posteromedial cortex
- In time, no change was denoted.
Differential Diagnosis:
- Periosteal desmoid
- Cystic bone tumor such as solitary bone cyst, intraosseous ganglion, giant cell tumor, benign cortical fibrous defect
Diagnosis: Periosteal desmoid
Discussion:
- A periosteal desmoid is a tumor-like alteration of the periosteum characterized by fibroblastic proliferation. Almost all cases are localized to posteromedial cortex of the femur.
- This location corresponds to the osseous site of attachment of the medial head of the gastrocnemius muscle and is lateral to the site of attachment of the tendon of the adductor magnus muscle.
- It were rarely found on the lateral cortical walls.
- It has predominence in children and in boys, frequent bilaterality, occasional persistence in adult life.
References:
1. Diagnosis of Bone and Joint Disorders, fourth edition, Resnick, volume 5, 4563-4566
2. Radiology, 1982, 143: 345-354, Distal femoral cortical defects, irregularities, and excavations
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