Table 1 Differential diagnosis of craniofacial fibrous dysplasia (CFD)
From: Craniofacial fibrous dysplasia: a challenge for general dental practitioners
Differential diagnosis | Clinical presentation | Radiographic appearance | Similarity with CFD | Difference with CFD |
|---|---|---|---|---|
Simple bone cyst41 | Usually asymptomatic and found incidentally Can cause pain or swelling if it expands | Well-defined, radiolucent, solitary lesion with smooth borders and no cortical destruction | Painless swellings Often discovered incidentally | Radiolucent with no internal radiopacities |
Ossifying fibroma42 | Well-defined and slow-growing benign tumour | Expansile lesion with a clearer cortical boundary | Painless bony expansion Mixed radiolucent-radiopaque appearance with cortical thinning and expansion | Well-demarcated and encapsulated |
Osseous dysplasia43 | Non-expansile growth pattern Usually asymptomatic | Radiolucent in early stage which tends to become mixed and eventually radiopaque as it matures | Asymptomatic Often discovered incidentally Ground-glass radiographic appearance | Non-expansile Usually no facial asymmetry |
Giant cell tumour44 | Painful, rapidly-enlarging mass May cause pathological fracture | Purely radiolucency Well-defined lesion Cortical thinning and possible expansion | Facial swelling Radiographically expansile with cortical thinning | Painful, rapidly expanding Radiographically purely radiolucent and multilocular |
Aneurysmal bone cyst45 | Painful and rapidly growing swelling May cause pathological fracture and tenderness | Multiloculated, radiolucent lesion ‘Soap bubble' appearance and cortical thinning or expansion | May result in facial asymmetry Radiographically expansile with cortical thinning or ballooning | Painful, rapidly expanding Cortical perforation may be seen |
Paget's disease of bone46 | Tends to be seen in older adults over the age of 50 More commonly involve multiple bones | Ground-glass/cotton wool appearance | May result in facial asymmetry Ground-glass radiographic appearance | Usually affects older adults Involves multiple bones in the skull |
Osteosarcoma47 | Malignant bone tumour Usually associated with pain, rapid growth and cortical destruction | A ‘sunburst' periosteal reaction and Codman's triangle (triangular area of new bone) appears | Bony swelling Radiographically, poorly-defined, mixed-density lesions with cortical disruption | Painful, fast-growing Causing paresthesia or tooth mobility Radiographically sunburst appearance |
Cherubism48 | Bilateral, symmetrical jaw swelling | Multilocular and expansile radiolucent lesions | Painless swelling of jaw and facial deformity Radiographically – cortical expansion and thinning | Bilateral, symmetrical jaw swelling in children, which regress after puberty |
CFD, craniofacial fibrous dysplasia | ||||
