Fibrous Cortical Defect Clinical Presentation

Updated: Apr 15, 2019
  • Author: Bernardo Vargas, MD; Chief Editor: Omohodion (Odion) Binitie, MD  more...
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Presentation

History and Physical Examination

Fibrous cortical defect (FCD) is encountered frequently in children and adolescents and is usually asymptomatic. [3, 12, 14]  Pain is rare and, if present, is usually associated with a fracture. FCD typically is localized in long bones. The most common sites are the femur and tibia. On rare occasions, it may be encountered in the vertebrae, clavicle, or bones of the upper limbs. The association of multiple FCDs with café-au-lait spots, multiple nevi, mental retardation, hypogonadism, and ocular and cardiovascular abnormalities is called Jaffe-Campanacci syndrome. [15]

FCD lesions have a typical and relatively distinct radiographic appearance. The lesion is radiolucent and is located eccentrically, usually in the distal metaphysis of a long bone. The cortex is thin, with sclerotic or scalloped margins. Lesions can be uniloculated or multiloculated. The longitudinal axis of FCD tends to be parallel to the axis of involved bone.

Commonly, FCD can be diagnosed by the orthopedic surgeon on the basis of clinical findings and imaging, without need for referral to orthopedic oncology. [16]