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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Diagnostic Checklist
TERMINOLOGY
Abbreviations
- Distal femoral avulsive irregularity (DFAI)
Synonyms
- Benign cortical irregularity of distal femur
- Avulsive cortical irregularity or tug lesion
- Cortical desmoid: Misnomer as biology & histology differ from true desmoid tumors (which are locally aggressive benign neoplasms)
Definitions
- Irregularity of posterior, medial distal femoral metaphyseal cortex deep to attachments of gastrocnemius muscle medial head or adductor magnus aponeurosis
- Benign self-limited lesion likely due to chronic avulsion
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Ultrasonographic Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Selected References
- Lerisson H et al: Radiographic/MR imaging correlation of the pediatric knee growth. Magn Reson Imaging Clin N Am. 27(4):737-51, 2019
- Kay M et al: Cortical desmoid of the humerus: radiographic and MRI correlation. Skeletal Radiol. 46(7):1011-5, 2017
- Tscholl PM et al: Cortical desmoids in adolescent top-level athletes. Acta Radiol Open. 4(5):2058460115580878, 2015
- Thapa MM et al: MRI of pediatric patients: part 2, normal variants and abnormalities of the knee. AJR Am J Roentgenol. 198(5):W456-65, 2012
- Hall FM: Cortical desmoid: a misnomer? AJR Am J Roentgenol. 197(4):1022; author reply 1023, 2011
- Vieira RL et al: MRI features of cortical desmoid in acute knee trauma. AJR Am J Roentgenol. 196(2):424-8, 2011
- Kontogeorgakos VA et al: Cortical desmoid and the four clinical scenarios. Arch Orthop Trauma Surg. 129(6):779-85, 2009
- Gould CF et al: Bone tumor mimics: avoiding misdiagnosis. Curr Probl Diagn Radiol. 36(3):124-41, 2007
- Connolly SA et al: Avulsive cortical irregularity and F-18 FDG PET. Clin Nucl Med. 31(2):87-9, 2006
- Jung C et al: Symptomatic cortical desmoids detected on knee SPECT. Clin Nucl Med. 27(6):437-8, 2002
- Donnelly LF et al: Chronic avulsive injury of the deltoid insertion in adolescents: imaging findings in three cases. Radiology. 211(1):233-6, 1999
- Yamazaki T et al: MR findings of avulsive cortical irregularity of the distal femur. Skeletal Radiol. 24(1):43-6, 1995
- Craigen MA et al: Symptomatic cortical irregularities of the distal femur simulating malignancy. J Bone Joint Surg Br. 76(5):814-7, 1994
- Resnick D et al: Distal femoral cortical defects, irregularities, and excavations. Radiology. 143(2):345-54, 1982
- Brower AC et al: Histological nature of the cortical irregularity of the medial posterior distal femoral metaphysis in children. Radiology. 99(2):389-92, 1971
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Diagnostic Checklist
TERMINOLOGY
Abbreviations
- Distal femoral avulsive irregularity (DFAI)
Synonyms
- Benign cortical irregularity of distal femur
- Avulsive cortical irregularity or tug lesion
- Cortical desmoid: Misnomer as biology & histology differ from true desmoid tumors (which are locally aggressive benign neoplasms)
Definitions
- Irregularity of posterior, medial distal femoral metaphyseal cortex deep to attachments of gastrocnemius muscle medial head or adductor magnus aponeurosis
- Benign self-limited lesion likely due to chronic avulsion
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Ultrasonographic Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Selected References
- Lerisson H et al: Radiographic/MR imaging correlation of the pediatric knee growth. Magn Reson Imaging Clin N Am. 27(4):737-51, 2019
- Kay M et al: Cortical desmoid of the humerus: radiographic and MRI correlation. Skeletal Radiol. 46(7):1011-5, 2017
- Tscholl PM et al: Cortical desmoids in adolescent top-level athletes. Acta Radiol Open. 4(5):2058460115580878, 2015
- Thapa MM et al: MRI of pediatric patients: part 2, normal variants and abnormalities of the knee. AJR Am J Roentgenol. 198(5):W456-65, 2012
- Hall FM: Cortical desmoid: a misnomer? AJR Am J Roentgenol. 197(4):1022; author reply 1023, 2011
- Vieira RL et al: MRI features of cortical desmoid in acute knee trauma. AJR Am J Roentgenol. 196(2):424-8, 2011
- Kontogeorgakos VA et al: Cortical desmoid and the four clinical scenarios. Arch Orthop Trauma Surg. 129(6):779-85, 2009
- Gould CF et al: Bone tumor mimics: avoiding misdiagnosis. Curr Probl Diagn Radiol. 36(3):124-41, 2007
- Connolly SA et al: Avulsive cortical irregularity and F-18 FDG PET. Clin Nucl Med. 31(2):87-9, 2006
- Jung C et al: Symptomatic cortical desmoids detected on knee SPECT. Clin Nucl Med. 27(6):437-8, 2002
- Donnelly LF et al: Chronic avulsive injury of the deltoid insertion in adolescents: imaging findings in three cases. Radiology. 211(1):233-6, 1999
- Yamazaki T et al: MR findings of avulsive cortical irregularity of the distal femur. Skeletal Radiol. 24(1):43-6, 1995
- Craigen MA et al: Symptomatic cortical irregularities of the distal femur simulating malignancy. J Bone Joint Surg Br. 76(5):814-7, 1994
- Resnick D et al: Distal femoral cortical defects, irregularities, and excavations. Radiology. 143(2):345-54, 1982
- Brower AC et al: Histological nature of the cortical irregularity of the medial posterior distal femoral metaphysis in children. Radiology. 99(2):389-92, 1971
