To investigate the association between nonossifying fibroma (NOF) and perilesional edema-like marrow signal intensity (ELMSI) on MRI and discuss the clinical and diagnostic implications of this finding.
Materials and methods
A retrospective search for “nonossifying fibroma” and “NOF” on knee MRI reports of patients up to 20 years of age over a 5-year period was performed. A total of 77 patients (34 males, 43 females, ages 11–20) were identified, and each MRI was reviewed to evaluate for ELMSI associated with the NOF. Statistical analysis was performed to determine if there was a correlation with the presence of perilesional ELMSI and age, gender, lesion size, or signal characteristics.
Twelve patients out of 77 (16%) had ELMSI associated with a NOF. Excluding patients who had additional findings of pathologic fracture (n = 2), a known potential complication of NOFs, and edema related to an adjacent osteoid osteoma (n = 1), a total of 9 patients (12%) had otherwise unexplained perilesional ELMSI. There was no statistically significant difference between patients with vs. without perilesional ELMSI with respect to age (p = 0.08), gender (p = 0.28), lesion size (p = 0.52), or appearance on fluid-sensitive sequences (p = 0.81).
ELMSI can be seen about NOFs encountered around the knee joint on MRI, which may represent active healing and/or involutional change of this “do not touch” lesion in cases where no other explanation is identified.
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The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.
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Farooq, M., Belair, J.A. Edema-like marrow signal intensity (ELMSI) associated with nonossifying fibroma (NOF) on MRI: an uncommon finding in a common bone lesion. Skeletal Radiol 52, 1511–1518 (2023). https://doi.org/10.1007/s00256-023-04312-9