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