Imaging recommendation · Musculoskeletal

Incidental ground-glass bone lesion, suspected fibrous dysplasia

Q: What's the alternative imaging for incidental ground-glass bone lesion, suspected fibrous dysplasia when pain / fracture concern?

MRI — MRI affected bone (iv contrast).

Recommended: X-ray + CT for characterization (ground-glass matrix) is the preferred imaging study for incidental ground-glass bone lesion, suspected fibrous dysplasia. Replacement of normal bone with fibro-osseous tissue.

Recommended study

X-ray + CT for characterization (ground-glass matrix)

XR No contrast Preferred Musculoskeletal Outpatient Reviewed 2026-05

Replacement of normal bone with fibro-osseous tissue. Monostotic (most common) or polyostotic (McCune-Albright).

If the default doesn't apply

Pain / fracture concern

MRI MRI affected bone IV contrast

Watch-outs

Polyostotic / McCune-Albright

Café-au-lait macules + endocrinopathies (precocious puberty, hyperthyroidism).

Pearls

Hallmark CT: ground-glass matrix in expansile lesion.
Common locations: ribs, proximal femur, craniofacial bones.
Shepherd's crook deformity of proximal femur in polyostotic disease.