Pediatric Cortical Desmoid

• Etiology: Benign self-limited entity that is stress related due to strain or “tugging” on insertion of adductor magnus tendon and medial head of gastrocnemius
• Imaging Radiograph:
  — Lucent irregular saucer shaped lesion along contour of posteromedial aspect of distal femoral metaphysis which has reactive sclerosis
  — Left greater than right
  — Often but not always bilateral
• Imaging MRI:
  — T1WI: Low signal intensity
  — T1WI post contrast: Enhances
  — T2WI: High signal intensity
• Note: This is a do not touch lesion
• DDX:
• Complications:
• Treatment:
• Clinical:
  — Most common at 10-15 years
  — Consider using the term “tug lesion” or “avulsive irregularity” rather than “cortical desmoid”
  — Usually asymptomatic and found incidentally

Radiology Cases of Cortical Desmoid