There is this vague suchondral marrow edema like signal and corresponding enhancement of the distal tibial metaphysis across the anterior and medial aspect with ? suchondral contour irregularity deep to the growth plate.
I don’t know what DDx to report.
I’m inclined to recommend CT, but I feel like I should suggest what I am considering in the differential.
I have received Many responses
The majority favor CRMO and recommend whole body MRI (which I recommended, though we don’t offer it at our facilities)
There were those who suggested infection or Brodies abscess and thought CT might help
Others favored stress fracture/ injury or included it in the DDx
A few included FOPE
Marcelo Bordalo offered what I thought was practical advice:
Without any clinical history, I would suggest early infection (metaphyseal BME with periosteal thickening). In the dd, bone stress injury and FOPE.
If blood count / CRP is normal, would suggest CT (to evaluate BME without an apparent cause).
If we see follow up imaging, I will share it
Thank you everyone for your assistance