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. 2026 Aug 20;7(8):1110–1117. doi: 10.1302/2633-1462.78.BJO-2026-0044.R1

Fig. 2.

Radiological images showing nonossifying fibroma-like lesions in 13- and 43-year-old female patients, shown as T1-weighted MRI, proton-density-suppressed MRI, and radiograph. Arrows point to the radiological lesions. Composite medical figure showing nonossifying fibroma-like lesions in 13- and 43-year-old female patients, with six labeled panels (a to f). Panels A and B show coronal MRI images of a distal femur with a well-defined lesion arising from the cortex of the femoral shaft above the knee; arrows indicate the lesion, and adjacent marrow signal alteration is visible in panel b. Panel c is a full-length radiograph of the lower limb showing a cortical-based lesion in the distal femur. Panel d is a microscopic histology image demonstrating spindle-cell proliferation with scattered vascular structures marked by asterisks and a 200 μm scale bar. Panel e is a follow-up coronal MRI showing the cortical lesion site with residual cortical irregularity indicated by an arrow. Panel f is a histology image showing numerous branching vascular channels within a fibrous stroma, highlighted by arrows, with a 200 μm scale bar.

Radiological nonossifying fibroma-like lesions in 13- and 43-year-old female patients. (a, e) T1-weighted MRI; (b) proton-density-suppressed MRI; and (c) radiograph. The white arrows point to the radiological lesions. (d) Haematoxylin-eosin-stained lesion in a 13-year-old female patient showing bland spindle-shaped cells with ovoid nuclei without any atypia, arranged in a storiform pattern, scattered osteoclast-type giant cells (*) and delicate haemosiderin deposits, characteristic of nonossifying fibroma. (e) T1-weighted MRI distal femur of a 43-year-old female patient. (f) Haematoxylin-eosin-stained lesion from a 43-year-old patient showing fibro-osseous tumour of woven bone with bland fibroblastic spindle cells. Prominent activated osteoblasts do not line the irregular trabeculae, and collagenous Sharpey-like fibres arise at right angles from the bone (black arrows), a typical feature of fibrous dysplasia.