Benign but Telling: Imaging Features of Fibrous Cortical Defects in Two Pediatric Patients

Fibrous cortical defects are common benign bone lesions in children and adolescents, usually discovered incidentally but occasionally symptomatic. We report two pediatric cases of fibrous cortical defects with different imaging approaches. The first case involved a child presenting with limb pain, in whom plain radiography revealed a small intracortical lytic lesion of the distal third of the left femoral diaphysis. The second case concerned a 10-year-old child with ankle pain and limping, in whom computed tomography demonstrated two small intracortical lytic lesions of the tibia and fibula with characteristic benign features. In both cases, imaging findings were consistent with fibrous cortical defects. These cases illustrate the typical radiographic and CT appearances of fibrous cortical defects and highlight the role of appropriate imaging modalities in establishing diagnosis and avoiding unnecessary invasive procedures in pediatric patients.