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Clinical presentation:
Incidental finding in a 15 year old girl.

There is a lobulated peripheral zone of increased density in the diaphysis of the femur. It has a sclerotic well-defined endosteal margin. The long axis is parallel to the bone and there is no cortical reaction. There is no abnormal adjacent soft tissue mass.

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[Differential]

cases that might resemble this pathology

[View large image] Osteoid osteoma. (case report) [View large image] Eosinophil granuloma. (case report)
[View large image] Fibrous dysplasia (case report). Patient is too young for Paget's disease. [View large image] Healed bone infarct in Sickle-cell disease. (case report)
[View large image] Healed 'brown tumours' of Hyperparathyroidism. (case report) include healed other benign cysts of bone. [View large image] Stress fracture (case report), include healing Looser zones
[View large image] Ewing's tumour (case report), usually has some bone destruction. [View large image] Osteosarcoma. (case report), usually has some bone destruction.
[View large image] Chondrosarcoma, but usually older and usually has some bone destruction.(case report) [View large image] Parosteal sarcoma (case report) usually older than this patient.
[View large image] Fluorosis, (case report), being a metabolic disorder is unlikely to be a solitary zone of sclerosis.

Metastasis is uncommon at this age.
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[London South Bank U.]

IDM April 2007