Evaluation of primary physicians’ awareness levels of non-ossifying fibromas and fibrous cortical defects by using referral documents

This study aimed to investigate the awareness levels of primary physicians regarding non-ossifying fibromas (NOFs)/fibrous cortical defects (FCDs) using patient referral documents. Referral documents of 62 male and 46 female patients (mean age: 11 [5-32] years) who were diagnosed with NOFs/FCDs based on radiological findings were retrospectively reviewed. The suspected diagnoses by primary physicians were classified as "NOF/FCD," "Benign," "Intermediate," "Malignant," and "No description." The Ritschl radiological classification of NOFs/FCDs and the relationship between the stages and suspected diagnoses were examined. NOFs/FCDs were diagnosed in 40 patients. The classifications were "Benign," "Intermediate," "Malignant," and "No description'' in 12, 3, 5, and 48 patients. Osteosarcoma was suspected in 4 patients. Among 63 patients with stage A Ritschl classification, NOFs/FCDs were diagnosed in 24 and osteosarcoma was suspected in 3. In 30 patients with stage B, NOFs/FCDs were diagnosed in 11 and osteosarcoma was suspected in one. Among patients with stages C and D, 3/10 and 2/5 patients, respectively, were diagnosed with NOFs/FCDs and a malignant bone tumor was suspected in 1 case with stage D. The suspected diagnosis was ``No description'' in 46%, 43.3%, 40%, and 40% of patients with stages A, B, C, and D, respectively. The ``primary physicians" awareness levels of NOF/FCD seemed insufficient, owing to a high rate of "No description." Plain radiography is a diagnostic technique for NOFs/FCDs, and NOF/FCD lesions commonly develop in children and young adults. Primary physicians need to be educated about the typical NOF/FCD radiological findings.