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MR Imaging of Sports-Related Pseudotumor in Children

Mid Femoral Diaphyseal Periostitis at Insertion Site of Adductor Musculature

¹ Department of Diagnostic Radiology, University Hospital of Bern, Inselspital, 3010 Bern, Switzerland.
² Department of Orthopedic Surgery, University of California, San Francisco, CA 94143.
³ Department of Radiology, University of California, San Francisco, CA 94143.

OBJECTIVE. The objective of this study was to review the imaging appearance of the femurs of five patients who had been referred from outside institutions after presenting with thigh pain and being given a preliminary diagnosis of primary malignant bone tumor. Typically, when making a diagnosis, physicians place emphasis on the characteristic appearances of diseases on MR imaging, but such appearances may be misleading. An awareness of the specific MR imaging pattern of stress-related partial muscle avulsion can lead to the correct diagnosis.

CONCLUSION. Femoral diaphyseal periostitis after a sports injury to the adductor musculature in children has a characteristic imaging appearance. This condition can initially appear to be misleadingly aggressive. Knowledge of the findings—particularly of the findings on MR imaging—in the proper clinical setting can help physicians make the correct diagnosis and eliminate unnecessary biopsy or inappropriate treatment.

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