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Figure 8b. Fibroxanthoma (nonossifying fibroma) in a 16-year-old girl. (a) Lateral radiograph of the knee shows a mixed lucent and sclerotic intramedullary lesion (arrowheads) along the posterior cortex of the distal femur. The sclerotic margin and multilocular appearance are typical of a fibroxanthoma. (b) Sagittal T2-weighted MR image of the knee shows areas of heterogeneous signal intensity (arrowheads) within the lesion. Images from 2%–3% of patients referred to the Orthopaedic Oncology Clinic showed features characteristic of fibroxanthoma but interpreted as a potential malignancy. Several of these patients arrived with only MR images and probably would not have been referred if a radiograph had been obtained for correlation.
