Cortical Lesions of the Tibia: Characteristic Appearances at Conventional Radiography

Abstract

Lesions that involve the cortex of the tibia are fairly common in radiology practice. However, the number of diseases that involve the tibial cortex is great, and it can be difficult to arrive at a limited differential diagnosis from radiographic findings. Categorization of lesions of the tibia into those that cause cortical destruction and those that cause cortical proliferation can help narrow the broad differential diagnosis. Lesions that cause cortical destruction include nonossifying fibroma, fibrous dysplasia, osteofibrous dysplasia, aneurysmal bone cyst, giant cell tumor, eosinophilic granuloma, Ewing sarcoma, neurofibromatosis, adamantinoma, osteoblastoma, chondromyxoid fibroma, hemangioendothelioma, renal cell metastatic disease, hemangioma, and hemangiopericytoma. Lesions that cause cortical proliferation include osteochondroma, stress fracture, osteoid osteoma, periosteal osteogenic sarcoma, diaphyseal dysplasia, venous stasis, cellulitis, chronic osteomyelitis, osteopathia striatum, and melorheostosis. Conventional radiography along with clinical and pathologic data can aid in diagnosis of the wide variety of disease processes that involve the tibial cortex.

Juxtacortical Chondromyxoid Fibroma of Bone: A Unique Variant

“…55 The lesion is represented radiographically by an eccentric area of geographic bone destruction (radiolucency) that is well circumscribed and often has a sclerotic periphery. 9,26,52 Microscopically, the lesion is lobular, with the lobules composed of varying proportions of fibrous, myxomatous, and chondroid tissue containing spindle-shaped to stellate cells which are more zonally numerous at the periphery of the lobules. 10,17,21,37,42,55 CMF was first described by Jaffe and Lichtenstein 21 in 1948 in which they described it as a distinctive benign tumor which could be mistaken for a chondrosarcoma.…”

A Case of Ewing’s Sarcoma of the Clavicle in Adults

“…Immunocytochemical, cytogenetic, and molecular genetic investigations have suggested a neural crest origin for these malignant tumors [4]. Ewing sarcoma of the clavicle is an unusual lesion and there are few reports about the surgical in the current literature [5].…”

Surface primary bone tumors: Systematic approach and differential diagnosis

“…Most patients present with painless enlargement of the tibia, a finding usually associated with anterior bowing or a pathologic fracture [21,24,25].…”

“…b Sagittal TSE T1-weighted image reveals anterior tibial bowing due to adamantinoma (large asterisk), with a small satellite lesion (small asterisk), extensive corticomedullary involvement and anterior soft-tissue extension (arrows). c On the STIR image, the main tumor (large asterisk) and satellite lesion (small asterisk) show high signal intensity and extend to soft tissues (arrow) through cortical involvement demonstrates unique osteoblastic rimming and bone zonation, which are not seen in the monostotic fibrous dysplasia [25].…”