A 7-year-old child has an incidental finding on X-ray of a 2 cm eccentric, lobulated, lucent lesion in the cortex of the distal femoral metaphysis with a well-defined sclerotic border. The child is asymptomatic. What is the diagnosis and recommended management?

• A Osteosarcoma, chemotherapy and surgery
• B Osteoid osteoma, NSAIDs
• C Non-ossifying fibroma, observation ✓
• D Chondroblastoma, curettage

Explanation

Non-ossifying fibroma (fibrous cortical defect) is a common benign asymptomatic lesion of childhood, typically eccentric and cortical in the metaphysis of long bones with a sclerotic border. Most are incidental findings requiring no treatment as they resolve spontaneously with skeletal maturity. Osteoid osteoma causes night pain with a central nidus. Osteosarcoma is aggressive. Chondroblastoma is epiphyseal.

Reference: Campbell's Operative Orthopaedics, 14th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.