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Nonossifying fibromas of the distal tibia: possible etiologic relationship to the interosseous membrane.

Muzykewicz DA, Goldin A, Lopreiato N, Fields K, Munch J, Dwek J, Mubarak SJ - J Child Orthop (2016)

Bottom Line: The remaining two lesions occurred directly posterior.The vast majority of distal tibial NOFs occur in a distinct anatomic location at the distal extent of the interosseous membrane, which may have etiologic implications.IV (case series).

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Surgery, Rady Children's Hospital, 3030 Children's Way, Suite 410, San Diego, CA, 92123, USA.

ABSTRACT

Purpose: Nonossifying fibromas (NOFs) present in a characteristic pattern in the distal tibia. Their predilection to this region and etiology remain imprecisely defined.

Methods: We performed a retrospective chart review of patients between January 2003 and March 2014 for distal tibial NOFs. We then reviewed radiographs (XRs), computed tomography (CT), and magnetic resonance imaging (MRI) for specific lesion characteristics.

Results: We identified 48 distal tibia NOFs in 47 patients (31 male, 16 female; mean age 12.3 years, range 6.9-17.8). This was the second most common location in our population (30 % of NOFs), behind the distal femur (42 %). Thirty-four lesions had CT and nine had MRI. Thirty-one percent were diagnosed by pathologic fracture. Ninety-six percent of lesions were located characteristically in the distal lateral tibia by plain radiograph, in direct communication with the distal extent of the interosseous membrane on 33 of the 34 (97 %) lesions with CT available for review and all nine (100 %) with MRI. The remaining two lesions occurred directly posterior.

Conclusions: The vast majority of distal tibial NOFs occur in a distinct anatomic location at the distal extent of the interosseous membrane, which may have etiologic implications.

Level of evidence: IV (case series).

No MeSH data available.


Related in: MedlinePlus

One of two lesions which localized directly posteriorly as opposed to adjacent to the interosseous membrane
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Fig5: One of two lesions which localized directly posteriorly as opposed to adjacent to the interosseous membrane

Mentions: Thirty-four (71 %) patients had a CT scan available for review. Direct communication with the distal extent of the interosseous membrane was seen on 33 (97 %) lesions (Figs. 3 and 4), with the exception being the one of the two aforementioned posteriorly based lesions for which we had CT (Fig. 5). Cortical breach was noted in 28 scans. This breach localized to the interosseous membrane attachment on all except for the one posteriorly localized lesion. Nine (19 %) patients had an MRI available for review, and all showed continuity of the distal extent of the interosseous membrane with the distal, lateral extent of the NOF (Fig. 6).Fig. 3


Nonossifying fibromas of the distal tibia: possible etiologic relationship to the interosseous membrane.

Muzykewicz DA, Goldin A, Lopreiato N, Fields K, Munch J, Dwek J, Mubarak SJ - J Child Orthop (2016)

One of two lesions which localized directly posteriorly as opposed to adjacent to the interosseous membrane
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4940240&req=5

Fig5: One of two lesions which localized directly posteriorly as opposed to adjacent to the interosseous membrane
Mentions: Thirty-four (71 %) patients had a CT scan available for review. Direct communication with the distal extent of the interosseous membrane was seen on 33 (97 %) lesions (Figs. 3 and 4), with the exception being the one of the two aforementioned posteriorly based lesions for which we had CT (Fig. 5). Cortical breach was noted in 28 scans. This breach localized to the interosseous membrane attachment on all except for the one posteriorly localized lesion. Nine (19 %) patients had an MRI available for review, and all showed continuity of the distal extent of the interosseous membrane with the distal, lateral extent of the NOF (Fig. 6).Fig. 3

Bottom Line: The remaining two lesions occurred directly posterior.The vast majority of distal tibial NOFs occur in a distinct anatomic location at the distal extent of the interosseous membrane, which may have etiologic implications.IV (case series).

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Surgery, Rady Children's Hospital, 3030 Children's Way, Suite 410, San Diego, CA, 92123, USA.

ABSTRACT

Purpose: Nonossifying fibromas (NOFs) present in a characteristic pattern in the distal tibia. Their predilection to this region and etiology remain imprecisely defined.

Methods: We performed a retrospective chart review of patients between January 2003 and March 2014 for distal tibial NOFs. We then reviewed radiographs (XRs), computed tomography (CT), and magnetic resonance imaging (MRI) for specific lesion characteristics.

Results: We identified 48 distal tibia NOFs in 47 patients (31 male, 16 female; mean age 12.3 years, range 6.9-17.8). This was the second most common location in our population (30 % of NOFs), behind the distal femur (42 %). Thirty-four lesions had CT and nine had MRI. Thirty-one percent were diagnosed by pathologic fracture. Ninety-six percent of lesions were located characteristically in the distal lateral tibia by plain radiograph, in direct communication with the distal extent of the interosseous membrane on 33 of the 34 (97 %) lesions with CT available for review and all nine (100 %) with MRI. The remaining two lesions occurred directly posterior.

Conclusions: The vast majority of distal tibial NOFs occur in a distinct anatomic location at the distal extent of the interosseous membrane, which may have etiologic implications.

Level of evidence: IV (case series).

No MeSH data available.


Related in: MedlinePlus