Imaging in osteofibrous dysplasia, osteofibrous dysplasia-like adamantinoma, and classic adamantinoma

Fibro-osseous lesions of the bone are well-recognized primary bone tumours. However, given the degree of overlap of imaging findings and variation in management of various sub-types, it is a widely accepted practice to perform a biopsy to obtain histopathological confirmation of the diagnosis. The following is a summary of the epidemiology, clinicopathological features, and review of the imaging features of fibro-osseous lesions, including osteofibrous dysplasia, osteofibrous dysplasia-like adamantinoma, adamantinoma, and lesions that closely mimic them. The illustrated examples are histologically proven cases that were presented to a tertiary referral teaching hospital and national bone and soft-tissue tumours unit. It is important that all radiologists are aware of the nature and imaging characteristics of these tumour sub-types, so that suspected lesions are recognized and appropriately referred to specialist bone tumour services for work-up and management.