Fig. 3

Representative radiographic features of fibrous dysplasia. a Femoral X-ray demonstrating diffuse involvement with fibrous dysplasia and a coxa vara (“shepherd’s crook”) deformity (red arrow). Note the irregular appearance of the distal femoral metaphyses (yellow arrowhead) resulting from FGF-23-mediated rickets. b Humeral X-ray demonstrating characteristic features of fibrous dysplasia, including homogenous “ground glass” appearance and cortical thinning. Bowing has occurred at a previously fractured site in the midshaft (red arrowhead). c X-ray from a patient with diffuse spinal FD and resulting thoraco-lumbar scoliosis. Note the presence of bilateral intramedullary femoral rods. d Technetium-99 scintigraphy scan showing increased tracer uptake in areas of fibrous dysplasia, including the skull, spine, right humerus, and right lower extremity (red arrowheads). Diffuse bilateral tracer uptake is also observed in the epiphyses of this growing adolescent. e T2-weight magnetic resonance imaging of the lower extremities showing well-demarcated lesions of intermediate to high signal intensity in the bilateral femurs (red arrows), corresponding to fibrous dysplasia lesions. f Computed tomography of the skull showing diffuse homogenous, “ground glass” involvement characteristic of craniofacial fibrous dysplasia. The bilateral optic canals are involved with fibrous dysplasia and widely patent (red arrows)