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Non Ossifying Fibroma

Non Ossifying Fibroma Symptoms |Signs | Treatment Options

 

Non ossifying fibroma (NOF) are fibrous defects in the cortical area of long bones.

Location

  • Metaphysis & Diaphysis of Long Bones with Cortical Epicenter.
  • Lower Limbs commonly involved, especially knee.

Age Predilection

  • It is common in children and adolescents (high incidence in 4 – 8 years)
  • Male to female ratio of 2:1.

Etiology

  • Etiology of NOF is Unknown.
  • It is postulated to occur secondary to developmental defects.
  • Multiple NOF with subcutaneous angiomas is termed as Jaffe-Campanacci Syndrome.

Symptoms

  • Clinically, the majority of NOF are Asymptomatic and are Incidental
  • Typically, a child presents with a history of pain after playing.
  • This pain is temporary in nature and can be localized to an area near to the lesion.
  • Swelling or edema is uncommon.

How is NOF diagnosed?

  • A plain radiograph is sufficient to diagnose NOF.
  • Plain radiograph shows a lesion involving cortex of metaphysis are of long bone not far from the site of pain.
  • It has sclerotic margin with accentuated trabeculations with homogenous matrix.
  • An MRI can be performed if another diagnosis is suspected, but is rarely done.

What is Treatment for NOF?

  • Majority of NOF require Conservative Management as they may either regress spontaneously or remain static.
  • Observation with serial follow up X ray every 6 months is required only if the lesion is suspected to be growing or involves more than 50 % or bone diameter.
  • Pathological fracture is rare, if noticed can be treated with brace or cast immobilization depending on the bone involved.
  • Surgery for NOF is rarely done in case of very large lesion (uncommon) or pathological fracture when conservative management fails).

For more details click on links below:

https://orthoinfo.aaos.org/en/diseases–conditions/nonossifying-fibroma/

https://radiopaedia.org/articles/non-ossifying-fibroma-1

 

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