Abstract
Background
Focal fibrocartilaginous dysplasia is a rare benign bone lesion of young children that causes deformities in the extremities. However, the pathogenesis and treatments have not been defined and the MR manifestations have been less well described.
Objective
To describe the MR manifestations of focal fibrocartilaginous dysplasia, especially on the T1-W three-dimensional (3-D) volumetric interpolated breath-hold examination (VIBE) sequence.
Materials and methods
In this retrospective study, the authors reviewed the MR and radiographic images, pathology and medical records of 21 cases of focal fibrocartilaginous dysplasia. All cases were evaluated by spin-echo MRI sequence. Among them, 17 cases were evaluated by T1-W 3-D VIBE sequence.
Results
The cohort consisted of 13 boys and 8 girls ages 4–75 months. In 14 cases, focal fibrocartilaginous dysplasia was located in the tibia, 3 in the femur and 4 in the ulna. MRI 3-D VIBE sequence findings showed all cases had hypointense fiber band structures in the bone defect areas. The fibrous bands in the lower extremities ended in the epiphysis or epiphyseal plate, and in the upper extremities the epiphysis or carpal bone. Ten cases had hyperintensities that might represent cartilage composition. Four cases had cartilage signals that were continuous with the epiphyseal cartilage. MR spin-echo sequence findings showed that bone marrow edema of the adjacent joint was observed in eight cases, enlargement of the epiphyseal plate in three cases and medial meniscus injury in five cases.
Conclusion
The 3-D VIBE sequence reveals useful details in focal fibrocartilaginous dysplasia.
Similar content being viewed by others
References
Bell SN, Campbell PE, Cole WG, Menelaus MB (1985) Tibia vara caused by focal fibrocartilaginous dysplasia. Three case reports. J Bone Joint Surg Br 67:780–784
Ruchelsman DE, Madan SS, Feldman DS (2004) Genu valgum secondary to focal fibrocartilaginous dysplasia of the distal femur. J Pediatr Orthop 24:408–413
Khanna G, Sundaram M, El-Khoury GY, Merkel K (2001) Focal fibrocartilaginous dysplasia: curettage as an alternative to conservative management or more radical surgery. Skelet Radiol 30:418–421
Ringe KI, Schirg E, Rosenthal H et al (2009) Unilateral tibia vara in a toddler caused by focal fibrocartilaginous dysplasia. J Radiol Case Rep 3:14–17
Ando A, Hatori M, Hosaka M et al (2008) A patient with focal fibrocartilaginous dysplasia in the distal femur and review of the literature. Tohoku J Exp Med 215:307–312
Jouve JL, Kohler R, Mubarak SJ et al (2007) Focal fibrocartilaginous dysplasia ("fibrous periosteal inclusion"): an additional series of eleven cases and literature review. J Pediatr Orthop 27:75–84
Albiñana J, Cuervo M, Certucha JA et al (1997) Five additional cases of local fibrocartilaginous dysplasia. J Pediatr Orthop B 6:52–55
Cockshott WP, Martin R, Friedman L, Yuen M (1994) Focal fibrocartilaginous dysplasia and tibia vara: a case report. Skelet Radiol 23:333–335
Gershkovich G, Kahan DM, Kozin SH, Zlotolow DA (2018) Outcomes in early versus late presentation of focal fibrocartilaginous dysplasia affecting the upper extremity: a review of 4 cases. J Pediatr Orthop 38:e360–e368
Meyer JS, Davidson RS, Hubbard AM, Conard KA (1995) MRI of focal fibrocartilaginous dysplasia. J Pediatr Orthop 15:304–306
Uchikoshi M, Ueda T, Nishiki S et al (2003) Usefulness of 3D-VIBE method in breast dynamic MRI: imaging parameters and contrasting effects. Nihon Hoshasen Gijutsu Gakkai Zasshi 59:759–764
Li HH, Zhu H, Yue L et al (2018) Feasibility of free-breathing dynamic contrast-enhanced MRI of gastric cancer using a golden-angle radial stack-of-stars VIBE sequence: comparison with the conventional contrast-enhanced breath-hold 3D VIBE sequence. Eur Radiol 28:1891–1899
Makabe T, Nakamura M, Moriyama R (2009) Applicability of the 3D-VIBE sequence to whole brain imaging. Nihon Hoshasen Gijutsu Gakkai Zasshi 65:945–951
Zheng ZZ, Shan H, Li X (2010) Fat-suppressed 3D T1-weighted gradient-echo imaging of the cartilage with a volumetric interpolated breath-hold examination. AJR Am J Roentgenol 194:W414–W419
Pavone V, Testa G, Riccioli M et al (2014) The natural history of focal fibrocartilaginous dysplasia in the young child with tibia vara. Eur J Orthop Surg Traumatol 24:579–586
Jibri Z, Chakraverty J, Thomas P, Kamath S (2013) Focal fibrocartilaginous dysplasia and spontaneously resolving bowing of the leg. J Pediatr 163:1527.e1
Dusabe JP, Docquier PL, Mousny M, Rombouts JJ (2006) Focal fibrocartilaginous dysplasia of the tibia: long-term evolution. Acta Orthop Belg 72:77–82
Nakase T, Yasui N, Araki N et al (1998) Florid periosteal reaction and focal fibrocartilaginous dysplasia. Skelet Radiol 27:646–649
Goldbach AR, Zlotolow DA, Fenerty SD et al (2019) Ulnar focal cortical indentation: a progressive, deforming variant of focal fibrocartilaginous dysplasia. Pediatr Radiol 49:187–195
Smith NC, Carter PR, Ezaki M (2004) Focal fibrocartilaginous dysplasia in the upper limb: seven additional cases. J Pediatr Orthop 24:700–705
Nakura A, Kawabata H, Tamura D, Sugita A (2017) Focal fibrocartilaginous dysplasia in the ulna with the radial head dislocation: a case report and literature review. J Pediatr Orthop B 26:41–47
Eren A, Cakar M, Erol B et al (2006) Focal fibrocartilaginous dysplasia in the humerus. J Pediatr Orthop B 15:449–452
Tian CY, Shang Y, Zheng ZZ (2012) Glenoid bone lesions: comparison between 3D VIBE images in MR arthrography and nonarthrographic MSCT. J Magn Reson Imaging 36:231–236
Kazuki K, Hiroshima K, Kawahara K (2005) Ulnar focal cortical indentation: a previously unrecognised form of ulnar dysplasia. J Bone Joint Surg Br 87:540–543
Gottschalk HP, Light TR, Smith P (2012) Focal fibrocartilaginous dysplasia in the ulna: report on 3 cases. J Hand Surg Am 37:2300–2303
Kim CJ, Choi IH, Cho TJ et al (1999) The histological spectrum of subperiosteal fibrocartilaginous pseudotumor of long bone (focal fibrocartilaginous dysplasia). Pathol Int 49:1000–1006
Thabet AM, Belthur MV, Herzenberg JE (2010) Spontaneous resolution of angular deformity of the distal femur in focal fibrocartilaginous dysplasia: a case report. J Pediatr Orthop B 19:161–163
Acknowledgments
Thanks are due to Luxin Lou, Xinmin Li, Lihua Gong, Wei Zhang, Dafei Zhou, Xiaoguang Cheng, Kebin Cheng and Aihong Yu for assistance with the study and valuable discussion.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflicts of interest
None
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Lou, L., Li, X., Gong, L. et al. Magnetic resonance imaging of focal fibrocartilaginous dysplasia — findings derived from a three-dimensional gradient echo sequence. Pediatr Radiol 52, 58–64 (2022). https://doi.org/10.1007/s00247-021-05175-9
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00247-021-05175-9