CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2023; 33(02): 150-156
DOI: 10.1055/s-0042-1760363
Original Article

Comparison of MRI Findings among Osteofibrous Dysplasia, Fibrous Dysplasia, and NonOssifying Fibroma of the Long Bone

Hiroki Kato
1   Department of Radiology, Gifu University, Gifu, Japan
Masaya Kawaguchi
1   Department of Radiology, Gifu University, Gifu, Japan
Rena Miyase
1   Department of Radiology, Gifu University, Gifu, Japan
1   Department of Radiology, Gifu University, Gifu, Japan
2   Department of Orthopedic Surgery, Gifu University, Gifu, Japan
Masayuki Matsuo
1   Department of Radiology, Gifu University, Gifu, Japan
› Author Affiliations


Background The characteristics of magnetic resonance imaging (MRI) findings among osteofibrous dysplasia (OFD), fibrous dysplasia (FD), and nonossifying fibroma (NOF) have yet to be determined.

Aims This study determines the differences of MRI features among OFD, FD, and NOF of the long bone.

Patients and Methods This study included 39 patients including 10 OFD, 13 with FD, and 16 with NOF of the long bone. All patients underwent preoperative MRI and histological examination. We retrospectively reviewed the MRIs and compared the imaging findings among the three pathologies.

Results The maximum diameter was significantly different among OFD (47.0 ± 18.6 mm), FD (59.0 ± 35.0 mm), and NOF (33.3 ± 15.0 mm) (p < 0.05). Multiplicity (60%, p < 0.01), eccentric distribution (100%, p < 0.05), septation (70%, p < 0.01), homogeneous intensity on T2-weighted images (70%, p < 0.01), homogeneous contrast enhancement (63%, p < 0.05), and intense contrast enhancement (88%, p < 0.01) were significantly more frequent in OFD. Centric distribution (69%, p < 0.01), cyst formation (54%, p < 0.01), and fluid-fluid level formation (31%, p < 0.01) were significantly more frequent in FD. Eccentric distribution (100%, p < 0.01), heterogeneous on T2-weighted images (100%, p < 0.01), predominant hypointensity on T2-weighted images (44%, p < 0.01), and the presence of intralesional hypointensity on T2-weighted images (88%, p < 0.01) were significantly more frequent in NOF.

Conclusion MRI features could differentiate OFD, FD, and NOF of the long bone.

Publication History

Article published online:
13 January 2023

© 2023. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

  • References

  • 1 Levine SM, Lambiase RE, Petchprapa CN. Cortical lesions of the tibia: characteristic appearances at conventional radiography. Radiographics 2003; 23 (01) 157-177
  • 2 Jung JY, Jee WH, Hong SH. et al. MR findings of the osteofibrous dysplasia. Korean J Radiol 2014; 15 (01) 114-122
  • 3 Jee WH, Choi KH, Choe BY, Park JM, Shinn KS. Fibrous dysplasia: MR imaging characteristics with radiopathologic correlation. Am J Roentgenol 1996; 167 (06) 1523-1527
  • 4 Franz D, Wechselberger J, Rasper M. et al. Milk cloud appearance-a characteristic sign of fibrous dysplasia on contrast-enhanced MR imaging. Eur Radiol 2019; 29 (07) 3424-3430
  • 5 Kinnunen AR, Sironen R, Sipola P. Magnetic resonance imaging characteristics in patients with histopathologically proven fibrous dysplasia-a systematic review. Skeletal Radiol 2020; 49 (06) 837-845
  • 6 Kushchayeva YS, Kushchayev SV, Glushko TY. et al. Fibrous dysplasia for radiologists: beyond ground glass bone matrix. Insights Imaging 2018; 9 (06) 1035-1056
  • 7 Jee WH, Choe BY, Kang HS. et al. Nonossifying fibroma: characteristics at MR imaging with pathologic correlation. Radiology 1998; 209 (01) 197-202
  • 8 Kahn LB. Adamantinoma, osteofibrous dysplasia and differentiated adamantinoma. Skeletal Radiol 2003; 32 (05) 245-258
  • 9 Khanna M, Delaney D, Tirabosco R, Saifuddin A. Osteofibrous dysplasia, osteofibrous dysplasia-like adamantinoma and adamantinoma: correlation of radiological imaging features with surgical histology and assessment of the use of radiology in contributing to needle biopsy diagnosis. Skeletal Radiol 2008; 37 (12) 1077-1084
  • 10 Bethapudi S, Ritchie DA, Macduff E, Straiton J. Imaging in osteofibrous dysplasia, osteofibrous dysplasia-like adamantinoma, and classic adamantinoma. Clin Radiol 2014; 69 (02) 200-208
  • 11 Castellote A, García-Peña P, Lucaya J, Lorenzo J. Osteofibrous dysplasia. A report of two cases. Skeletal Radiol 1988; 17 (07) 483-486
  • 12 Sakamoto A, Oda Y, Iwamoto Y, Tsuneyoshi M. A comparative study of fibrous dysplasia and osteofibrous dysplasia with regard to expressions of c-fos and c-jun products and bone matrix proteins: a clinicopathologic review and immunohistochemical study of c-fos, c-jun, type I collagen, osteonectin, osteopontin, and osteocalcin. Hum Pathol 1999; 30 (12) 1418-1426
  • 13 Fisher AJ, Totty WG, Kyriakos M. MR appearance of cystic fibrous dysplasia. J Comput Assist Tomogr 1994; 18 (02) 315-318
  • 14 Fitzpatrick KA, Taljanovic MS, Speer DP. et al. Imaging findings of fibrous dysplasia with histopathologic and intraoperative correlation. Am J Roentgenol 2004; 182 (06) 1389-1398
  • 15 Błaż M, Palczewski P, Swiątkowski J, Gołębiowski M. Cortical fibrous defects and non-ossifying fibromas in children and young adults: the analysis of radiological features in 28 cases and a review of literature. Pol J Radiol 2011; 76 (04) 32-39