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Cortical desmoid and the four clinical scenarios

  • Orthopaedic Surgery
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Abstract

We reviewed four patients diagnosed with a cortical desmoid lesion at the distal posterior medial femur. Each case reflects a clinical scenario that can be present. Cortical desmoid is a benign, self-limited entity which occasionally can exhibit aggressive radiologic features. Here, we present the specific imaging features in association with patients history and clinical findings facilitating establishment of correct diagnosis. Exact diagnosis is important in order to avoid unnecessary biopsy and complicated therapeutic strategies.

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References

  1. Johnson LC, Genner BAIII, Engh CA, Borwn RH (1968) Cortical desmoids. Proceedings of the American Academy of Orthopaedic Surgeons. J Bone Joint Surg Am 50:828

    Google Scholar 

  2. Simon H (1968) Medial distal metaphyseal femoral irregularity in children. Radiology 90:258

    Google Scholar 

  3. Suh JS, Cho JH, Shin KH et al (1996) MR Appearance of distal femoral cortical irregularity. J Comput Assist Tomogr 20:328–332. doi:10.1097/00004728-199603000-00031

    Article  PubMed  CAS  Google Scholar 

  4. Bufkin WJ (1971) The avulsive cortical irregularity. Am J Roentgenol Radium Ther Nucl Med 112(3):487–492

    PubMed  CAS  Google Scholar 

  5. Kimmelstiel P, Rapp I (1951) Cortical defect due to periosteal desmoids. Bull Hosp Joint Dis 12:286

    PubMed  CAS  Google Scholar 

  6. Dunham WK, Marcus NW, Enneking WF, Haun C (1980) Developmental defects of the distal femoral metaphysis. J Bone Joint Surg Am 62(5):801–806

    PubMed  CAS  Google Scholar 

  7. Gould CF, Ly JQ, Lattin GE, Beall DP, Sutcliffe JB (2007) Bone tumor mimics: avoiding misdiagnosis. Curr Probl Diagn Radiol 36:124–141. doi:10.1067/j.cpradiol.2007.01.001

    Article  PubMed  Google Scholar 

  8. Resnick D, Greenway G (1982) Distal femoral cortical defects, irregularities, and excavations. Radiology 143:345–354

    PubMed  CAS  Google Scholar 

  9. Resnic D, Kyriakos M, Greenway G (2005) Tumors and tumor-like lesions of bone: imaging and pathology of specific lesions. In: Resnic D, Kransdorf M (eds) Bone and joint imaging, 3rd edn. Elsevier Saunders, Philadelphia, pp 1121–1198

  10. Barnes GR, Gwinn JL (1974) Distal irregularities of the femur simulating malignancy. Am J Roentgenol Radium Ther Nucl Med 122:180

    PubMed  Google Scholar 

  11. Kohler A (1928) Roentgenology: the borderlands of the normal and early pathological in the skiagram, 5th edn. William Wood, New York, pp 164

    Google Scholar 

  12. Pennes DR, Braunstein EM, Glazer GM (1984) Computed tomography of cortical desmoid. Skeletal Radiol 12:40–44. doi:10.1007/BF00373175

    Article  PubMed  CAS  Google Scholar 

  13. Williams PL, Warwick R (eds.) (1980) Gray’s anatomy, 36th edn. Churchill Livingston, Edinburgh, pp 394, 607–608.

  14. Ritschl P, Karnel F, Hajek P (1988) Fibrous metaphyseal defects—determination of their origin and natural history using a radiomorphological study. Skeletal Radiol 17:8–15. doi:10.1007/BF00361448

    Article  PubMed  CAS  Google Scholar 

  15. Ritschl P, Hajek PC, Pechmann U (1989) Fibrous metaphyseal defects. Magnetic resonance imaging appearances. Skeletal Radiol 18:253–259. doi:10.1007/BF00361201

    Article  PubMed  CAS  Google Scholar 

  16. Jee WH, Choe BY, Kang HS et al (1998) Nonossifying fibroma: characteristics at MR imaging with pathologic correlation. Radiology 209:197–202

    PubMed  CAS  Google Scholar 

  17. Greyson ND, Pang S (1981) The variable bone scan appearances of nonosteogenic fibroma of bone. Clin Nucl Med 6:242–245. doi:10.1097/00003072-198106000-00002

    Article  PubMed  CAS  Google Scholar 

  18. Jung C, Choi YY, Cho S, Park KC (2002) Symptomatic cortical desmoids detected on knee SPECT. Clin Nucl Med 27(6):437–438. doi:10.1097/00003072-200206000-00011

    Article  PubMed  Google Scholar 

  19. Goodin GS, Shulkin BL, Kaufman RA, McCarville MB (2006) PET/CT characterization of fibroosseous defects in children: 18F-FDG uptake can mimic metastatic disease. AJR Am J Roentgenol 187(4):1124–1128. doi:10.2214/AJR.06.0171

    Article  PubMed  Google Scholar 

  20. Mirra JM (1989) Parosteal tumors. In: Mirra JM (ed) Bone tumors: clinical, radiologic, and pathologic correlation. Lea & Febiger, Philadelphia, pp 1605–1610

    Google Scholar 

  21. Herring JA (2002) Imaging. In: Herring JA (ed) Tachdjian’s Pediatric Orthopaedics, 3rd edn. W.B Saunders, Philadelphia, pp 132–3

  22. Allen DH (1953) A variation of diaphyseal development which simulates the roentgen appearance of primary neoplasms of bone. AJR Am J Roentgenol 69:940

    CAS  Google Scholar 

  23. Dunham WK, Marcus NW, Enneking WF, Haun C (1980) Developmental defects of the distal femoral metaphysis. J Bone Joint Surg Am 62(5):801–806

    PubMed  CAS  Google Scholar 

  24. Helms C (2005) Don’t touch lesions. In: Clyde A. Helms ed. Fundamentals of skeletal radiology, 3rd edn. Elsevier Saunders, Philadelphia, pp 55–77

  25. Fletcher CDM, Unni KK, Mertens F (2002) World Health Organization classification of tumours. Pathology and genetics of tumours of soft tissue and bone. IARC Press, Lyon, pp 279–282

  26. Velchik MG, Heyman S, Makler PT Jr, Goldstein HA, Alavi A (1984) Bone scintigraphy differentiating benign cortical irregularities of the distal femur from malignancy. J Nucl Med 25:72–74

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. University Of Ioannina, Medical School, Ioannina, Greece

    Vasilelos A. Kontogeorgakos, Theodore Xenakis, Dionysios Papachristou, Anastasios Korompilias & Alexander Beris

  2. University Of Athens, Medical School, Athens, Greece

    Anastasios Kanellopoulos

  3. Duke University Medical School, Durham, NC, USA

    Brian Brigman

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  1. Vasilelos A. Kontogeorgakos
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  2. Theodore Xenakis
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  3. Dionysios Papachristou
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  4. Anastasios Korompilias
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  5. Anastasios Kanellopoulos
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  6. Alexander Beris
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  7. Brian Brigman
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Correspondence to Vasilelos A. Kontogeorgakos.

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Kontogeorgakos, V.A., Xenakis, T., Papachristou, D. et al. Cortical desmoid and the four clinical scenarios. Arch Orthop Trauma Surg 129, 779–785 (2009). https://doi.org/10.1007/s00402-008-0687-6

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  • DOI: https://doi.org/10.1007/s00402-008-0687-6

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