Benign Bone Lesions
Incidentally discovered NOF (and other benign lesions) can be managed with analgesia with NSAIDs and acetaminophen as needed with non-urgent orthopedic referral. If the NOF is more than 50% the diameter of the bone or the pain is worse with weight bearing, it should be treated as impending stress fracture with crutches, toe-touch weight bearing, appropriate analgesia, and timely orthopedic follow-up.
Pathologic fractures, even those associated with benign lesions, should receive immediate orthopedic consultation as they may require surgical management. Bone lesions should be referred for orthopedic follow-up since even benign lesions occasionally behave aggressively or lead to pathologic fracture.