 致谢：该病例来自auntminnie Board Review——Musculoskeletal 翻译：赵文韬 江门市中心医院 放射科 A 13-year-old boy with leg pain after a fall while playing soccer. Radiographs are shown below. 一名13岁男孩在踢足球时摔倒，后感觉腿疼。X线平片如下所示。
The following radiographs were obtained three years later after another injury while playing sports. 三年后，他在一次运动中又受伤后，再次拍X线片如下。
Which of the following is the most likely diagnosis? A. Chronic osteomyelitis B. Eosinophilic granuloma C. Nonossifying fibroma D. Fibrous dysplasia E. Aneurysmal bone cyst 以下哪项是最可能的诊断？ A.慢性骨髓炎 B嗜酸性肉芽肿 C非骨化性纤维瘤 D骨纤维异常增生症 E动脉瘤样骨囊肿 Correct answer：C Explanation: On the initial radiographs, incidentally noted is a cortically based centrally radiolucent lesion with well-defined thin sclerotic rim and slightly scalloped contour in the distal tibial metaphysis. The superior portion of the lesion demonstrates more extensive sclerosis. Follow-up radiographs three years later demonstrate interval enlargement of the lesion, now occupying greater than 50% of the tibial diameter, with mild expansion of the anterior tibial cortex. The lesion is now positioned in the metadiaphysis, reflecting interval growth of the tibia. 正确答案：C 解释： 起初的X线平片上，偶然发现在胫骨远端干骺端一个以骨皮质为基础的中心透光性病变，边缘清晰的骨质硬化边，形态欠规则。病变的上部边缘硬化明显。三年后的随访X光平片显示病变间隔扩大，占胫骨直径的50%以上，胫骨前骨皮质轻度膨胀。病变现在位于干骺端，反映了胫骨的间隔生长。 Imaging findings of NOFs ·Nonossifying fibromas are cortically based lesions, with a predilection for metaphysis. ·With growth, lesions can “migrate” to the metadiaphysis over time. ·Central location seen in gracile bones. ·The knee and tibia are the most commonly affected bones. ·The long axis of lesion is parallel with the long axis of bone. NOFs的影像学表现 ·非骨化性纤维瘤是以骨皮质为基础的病变，好发于干骺端。 ·随着年龄增长逐渐移向骨干。 ·病变中心可见骨嵴。 ·膝关节和胫骨是最常见的受累骨。 ·病变的长轴平行于骨干。 |
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