TEXT BOOK READING

DAVID SUTTON VOL.2

PAGE 1130-1140

FIBROUS DYSPLASIA (FD)

By : Dwi Damar Andriyani

Consultant : dr. Edy Moeljono, Sp.Rad (K)RA
Sutton page 1130-1140

 Congenital skeletal anomalies

 Skeletal dysplasia
1. Cleidocranial dysplasia
2. Picnodisostosis
3. Acroosteolisis
4. Osteogenesis imperfecta
5. Fibrogenesis imperfecta
6. Osteopetrosis
7. ........
8. Fibrous dysplasia
9. .......
40. Achondrogenesis
 Chromosomal disorder
 Introduction

 Aetiology : unknown
 Female>male
 Bone may be affected
– Pelvis
– Femur
– Skull
– Spine/vertebral collapse unusual
 Usually found incidentally/ follow pathological
fracture
 Onset : 10-30 yr old or first decade
 Prognosis : worse when lesion occurs early in life
 Pathology

Medullary bone replaced by:

Fibrous tissue
Cystic containing blood/serous fluid

Fibrous tissue undergoes varying degree of

abnormal ossification

Increase density (dependent on the

extent ossification)
•Patchy
•Cotton wool appearance
•Homogenousground glass appearance
Characteristic Fibrous Dysplasia

 Location
– Diametaphyseal
– Bone end may be involved after fusion
– In child may Involve epiphysis
 Found in 2 form:
1. Poliostotic
 50% skeleton may be involved
 Asimetri & distributed unilateral
2. Monostotic
 More likely to enlarge in adult life
Radiologycal Features

 Margin
– Smooth dense
– Well define
– Expanded the bone
 Cortex scalloped & thinned but intact
– Tend to be multilocular
– Expand down the medulla rather than
cause cortical expansion
 Various degree of central ossification
FD in the Proximal Femur.

Fig. 35.47 The lesions are

well defined, often with a
very thick 'rind' around them,
and show various degrees of
central mineralisation. The
site is typical for fibrous
dysplasia.
Fibrous dysplasia Of the Tibia

 Fig. 35.48. A
multilocular, partly
cystic, expansile lesion
 of the midshaft tibia is
surrounded by a thick rim
of reactive sclerosis.
 Polycystic case of FD

Fig. 35.51.(A) marked enlargement and deformity of the pelvis and proximal
femur. There is marked bony expansion with extensive cyst formation. The shepherd's
crook deformity has been stabilised. (B) The CT scan shows the mixed pattern of
tissues seen in fibrous dysplasia, ranging from cystic through ground-glass to heavily
mineralised tissue.
 Fibrous dysplasia.

(A) There is thickening with sclerosis of the frontal bone, the floor
of the anterior cranial fossa and the base of the skull extending
back to the sphenoid sinus, which is replaced by dense amorphous
bone. (B) The CT scan shows expanded and abnormally mineralised
bone occupying mainly the left side of the skull base. Considerable
facial deformity is present.
 Resume

Fibrous dysplasia
1. Aetiology & Patology
2. Form
– Polyostotic
– Monostotic
3. Radialogical feature
– Location : diametafisial, medulla
– Margin
 Well define, expansion to the cortex (cortex
thin, scalloped, but intact)
– Center
 Varying degree central mineral ossification
 QUIZ

1. Please describe this

pictures!
2. What is the most likely
diagnosis for this
pictures?

Fig. 35.47, PAGE 1131

TERIMAKASIH