periosteal desmoid ( RID4293 )
There is a cortically based focus of intermediate T1 / bright T2 signal at the posteromedial supracondylar femur, slightly cranial to the physeal scar. This was previously referred to as a periosteal desmoid, which was a misnomer. This is now considered to be either a normal developmental variant or residua of avulsive stress at the adductor insertion. As per the attached article, this cystic variant is considered by some to be a fibrous cortical defect. Note the stripping of the Quadriceps Continuation in slide 4 (the most superficial component of the extensor mechanism) anterior to the patella, with extension in this case cranially and medially, superficial to the distal quadriceps tendon and medial patellar retinatuculum. Edema surrounds the delaminated Quadriceps Continuation. This corresponds to the area of pain and tenderness on exam. [ Article ]
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