Bone Lesions Case 2 History/Physical Exam

Patients with NOF are usually children or young adult males. Pain, if present, is typically chronic and bony (not involving the joint) and worse with weight bearing. A history of acute pain or trauma should raise suspicion of pathologic fracture through the lesion.

In the absence of pathologic fracture, there are typically no significant findings on physical exam. NOFs are contained within the bone, so there is no palpable deformity. A palpable mass or soft tissue swelling increases the likelihood of pathologic fracture. ROM of joints near painful areas should be checked gently in case of impending pathologic fracture.