Tatiane shared these images from another article, too…I will report it as a healing fracture with probable adjacent post-traumatic cyst, and suggest MRI follow up after the fracture is healed, if they think it’s indicated, to look for resolved marrow edema.
On Fri, Sep 15, 2023 at 11:20 AM hilary umans <hilary.umans> wrote:
MRI 5 weeks after injury, no internal derangement
Edge of image lesion with what looks like central mineralization and tremendous perilesional edema…I reported probable osteoid osteoma and recommended CT
I don’t know the details of the sports injury, but this is complete or nearly complete non-displaced proximal tibial shaft fracture with callus.
That endosteal rounded lesion measures up to 1cm in maximal dimension and abuts the margin of the fracture; there is no internal mineralization.
I know we teach that osteoid osteoma and stress fracture are a classic differential diagnosis, but I’ve never seen an instance where both co-exist.
This is definitely a fracture.
Can I know if this is an osteoid osteoma?
This is a serious head-scratcher.
What do I report? It will take months for the tibial fracture to heal.
Should I recommend a follow up MRI? and / or CT? In 4-6 months?
Or what????
