A radiolucent defect in bone that is a cause of a pathologic fracture and nocturnal pain in the legs in children is
Correct Answer: A fibrous coical defect
Description: A fibrous coical defect (nonossifying fibroma) is a non-neoplastic process that most commonly involves the tibia, fibula, and femur. It creates an irregular, sharply demarcated radiolucent defect in the metaphyseal coex. It is a frequent cause of a pathologic fracture. The defect characteristically presents with nocturnal pain in the legs. Fibrous dysplasia refers to a benign, non-neoplastic process of bone (ribs and femur) in which bone is replaced by fibroconnective tissue (woven bone). It may be involved in a single bone (monostotic) or many bones (polyostotic), the latter often associated with Albright's syndrome. This syndrome consists of abnormal skin pigmentation (cafae au lait spots), polyostotic fibrous dysplasia, and precocious sexual development, usually in females. Fibrous dysplasia is not associated with nocturnal pain. An aneurysmal bone cyst is a benign condition (most commonly seen in children) that characteristically causes enlargement of the bone. The femur and the veebra are most commonly involved. The cyst is composed of hemorrhagic spaces and reactive-appearing giant cells. On x-ray, it appears as a multicystic, radiolucent lesion. It is not associated with nocturnal bone pain. Enchondromas (chondromas) are benign, generally asymptomatic, solitary or multiple cailaginous tumors that result from a failure of normal endochondral ossification below the growth plate. They develop within the medullary cavity of the bone. The risk for transformation into a chondrosarcoma is greatest when multiple lesions are present. OIlier's disease refers to multiple enchondromas that most frequently involve the bones of the hands and feet. There is no association with nocturnal pain or pathologic fractures. An osteoma is a solitary benign tumor usually confined to the skull and facial bones, which may be associated with Gardner's hereditary polyposis syndrome. It is not associated with nocturnal pain or a pathologic fracture. Ref: Maheshwari 6e pg 236.
Category:
Orthopaedics
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