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Clinical presentation:
12 year old girl with some left knee discomfort.

There is an eccentric lytic lesion in the distal diaphysis of the left femur, extending into the metaphysis. The lesion is lobulated with variable thinning of the adjacent cortex, but no cortical reaction. The process occupies the medial one third of the shaft. The lesion's borders appear sclerotic with a narrow zone of transition between abnormal and normal bone. The variable thickness of the margin is assumed obliquity. There is no indication of an 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] Simple bone cyst. (case report)
[View large image] Bone infarct in Sickle-cell disease. (case report) [View large image] Haemangioma (case report), but unilateral.
[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] 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