Gray‐scale and Doppler characteristics of fibrous cortical defects in a child

Abstract

We report the case of a 9.5-year-old boy who underwent sonographic and radiographic examinations because of knee pain. Two fibrous cortical defects were discovered, in his right femur and left tibia; the femoral lesion was seen more easily on sonography than on radiography. On gray-scale sonography, the lesions were characterized as a scalloped indentation of the cortical surface containing hypoechoic soft tissue. On color Doppler sonography, discrete vessels were found at the periphery and within the substance of the lesions, and on spectral Doppler analysis, low-resistance arterial flow was detected in those vessels. Follow-up examinations performed 10 and 19 months after our initial examination showed signs that the lesions were healing. The diagnosis of fibrous cortical defect was suggested by the gray-scale and Doppler sonographic characteristics and confirmed on radiography. Although radiography is required to document these lesions if found incidentally on sonography, follow-up examinations using only sonography may be feasible.

The Value of Ultrasound in Diagnosis and Follow-up of Fibrous Cortical Defect

“…In our opinion, follow-up examinations should either consist of repeated CT scans or US examinations, both methods yielding similar results. In the literature, we found that Loberant and all [12] presented a case of FCD similar to ours. Their US characteristics of the lesion were very similar, also regarding the echogenic foci and increased vascularisation within the lesion, which was considered as bone remodelling and healing.…”

Sonographic Hair-on-end Sign in Osteosarcoma

“…Osseous abnormalities can be evaluated using multiple imaging modalities. The utility of sonography to evaluate osseous abnormalities has been well documented in trauma,[ 1 ] as well as in benign[ 2 ] and malignant bone lesions. [ 3 4 5 6 ] Discontinuities in the normal smooth cortical contour of long bones are well seen on ultrasound.…”