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.

Age Predilection

  • 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).


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    Apollo Hospitals, Bengaluru

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