Fibrous Dysplasia of Maxilla

 Fibrous dysplasia of the facial skeleton commonly involves the maxilla.  It commonly involves one maxilla.  CT scan shows a lesion that is confined to the bone with no soft tissue component. It is helpful in distinguishing fibrous dysplasia from a malignancy. Features of malignancy include osteolysis, destruction of sclerotic margins, and cortical destruction with soft tissue extension.  The bony lesion shows a homogenous matrix with obliteration of maxillary sinus cavity.

Fibrous Dysplasia of Temporal Bone

Fibrous dysplasia of bone is characterized by the presence of fibroosseous tissue in the interior of the affected part or parts of the bone and occurs more frequent in female patients In the head and neck, the skull and facial bones are involved in 10-25% of cases of monostotic fibrous dysplasia and in 50% of the polyostotic variety. Involvement of the temporal bone is relatively rare and three patterns are described i.e. the pagetoid, sclerotic and cystic. The pagetoid pattern is the commonest and shows both sclerotic and radiolucent areas. Sclerotic lesions are homogenously dense whereas the cystic variety is characterized by a spherical and oval lucency surrounded by a dense bony shell.

Reported by Teleradiology Providers

Fibrous Dysplasia-CT

Bony expansile lesion with ground glass involving the right maxilla with involvement of alveolar, zygomatic arch, inferior orbital rim with partial obliteration of maxillary sinus Likely fibrous dysplasia.

Case by-

Dr.Sumer K Sethi, MD
Sr Consultant Radiologist ,VIMHANS and CEO-Teleradiology Providers
Editor-in-chief, The Internet Journal of Radiology
Director, DAMS (Delhi Academy of Medical Sciences)

Fibrous Dysplasia-MRI

Fibrous dysplasia - Fibrous dysplasia (FD) is a benign condition associated with normal bone marrow replacement by proliferative fibro-osseous tissue with varied quantities of stroma and bone. FD may affect only one (monostotic form) or multiple bones (polyostotic form). It is a relatively common disease and is most frequent in teenagers and young adults.
Affected bones will be expanded and strongly enhance after intravenous contrast medium injection. A noncontrasted CT scan with bone algorithm will show the classic "ground glass" appearance of fibrous dysplasia. MRI shows homogeneous low signal on T1WI, unless there is pathological fracture. On T2WI, the lesion is heterogeneous depending on the amount of fibro-osseous tissue, cellularity, cystic alterations, hemorrhage and cartilaginous tissue. The lesions usually have well defined borders. All the sequences show a hypointense halo that corresponds to sclerotic margins. MRI is the modality of choice to demonstrate the internal structures of the lesion and evaluate disease extension, especially in cases due for surgical treatment.

Case by-Dr.Sumer K Sethi, MD

Consultant Radiologist ,VIMHANS and CEO-Teleradiology Providers

Editor-in-chief, The Internet Journal of Radiology

Director, DAMS (Delhi Academy of Medical Sciences)