Non Ossifying Fibroma
Non ossifying fibroma (NOF) are fibrous defects in the cortical area of long bones.
- Metaphysis & Diaphysis of Long Bones with Cortical Epicenter.
- Lower Limbs commonly involved, especially knee.
- It is common in children and adolescents (high incidence in 4 – 8 years)
- Male to female ratio of 2:1.
- 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.
- 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.
- 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).