[Metaphyseal fibrous defect].
OBJECTIVE
The aim of the study was to identify predisposition to the development of metaphyseal fibrous defect (MFD) on the skeleton and to select appropriate imaging methods and examination for detection of atypically located or larger cortical lesions.


METHODS
A group of 38 randomly selected patients with MFD was analyzed. It comprised of 27 boys and 11 girls at average ages of 13.7 years and 15.5 years, respectively. The youngest child was 4 and the oldest patient was 30 years old.


METHODS
Thirty-two patients with a history of trauma and six patients with problems associated with sports activities were examined by plain radiography. Additional examination included CT scans in eight, MRI in two, scintigraphy in 17, angiography in seven and genetic examination in three patients. Histological evaluation confirming the presence of MFD was carried out in seven patients.


RESULTS
The majority of lesions (75.6 %) were found around the knee, 17 in the distal femur and 17 in the proximal tibia. Eight lesions (17.8 %) were present in the distal tibia and three (6.6 %) were at other sites. Multifocal lesions, when detected, were associated with von Recklinghausen's neurofibromatosis, Marfan's disease or familiar occurrence. In most cases the diagnosis was made on the basis of plain radiographic findings. For large lesion in atypical locations, examination by CT, MRI, scintigraphy or biopsy were recommended.


CONCLUSIONS
In this section the authors discussed other pathologic conditions that must be distinguished from MFD.


CONCLUSIONS
The bones around the knee were affected most often. Multifocal MFD lesions were associated with von Recklinghausen's neurofibromatosis, Marfan's disease or familiar occurrence. The diagnosis was usually based on plain X-ray examination. To diagnose atypical and large lesions, advanced imaging (CT, MRI), scintigraphy or biopsy were recommended.
Koudelová
J
J
Radiodiagnostická Klinika LF UK a FN Plzen.
Koudela
K
K
Kunesová
M
M
Koudela
K
K
D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D005350:Fibroma / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D011859:Radiography