Orthopedic Surgery for Fibrous Dysplasia Clinical Presentation

Updated: Oct 14, 2022
  • Author: Bernardo Vargas, MD; Chief Editor: Harris Gellman, MD  more...
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History and Physical Examination

Pain is a common sign of fibrous dysplasia in symptomatic patients. [17]  Most commonly, patients are asymptomatic. Patients usually seek medical care because of either painful swelling and deformity or a pathologic fracture through a weakened bone. Long bones are commonly affected. The femur is the most common location; other sites typically affected are the tibia, maxilla, and skull.

Nonskeletal manifestations include abnormal cutaneous pigmentation, precocious puberty, hyperthyroidism, Cushing disease, hyperparathyroidism, and hypophosphatemic rickets. McCune-Albright syndrome is defined as the triad of precocious puberty, polyostotic fibrous dysplasia, and cutaneous pigmentation. Typically, only females are affected by precocious puberty, [19]  but the other endocrine abnormalities occur equally in males and females. All of these abnormalities are thought to be due to the same underlying mutation.



Fracture is the most common complication of fibrous dysplasia. In polyostotic disease, fracture occurs in more than 50% of cases.

Deformity may occur in weightbearing bones.

Malignant transformation occurs in fewer than 0.5% of cases. It is more likely to occur when polyostotic disease exists or after treatment with radiation therapy. Typically, malignant transformation occurs during the third or fourth decade of life. [14]  Benign tumors have also been associated with fibrous dysplasia. [20]

Patients with McCune-Albright syndrome have a high incidence of scoliosis (probably exceeding 50%). [10]