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Updated: Jun 10, 2026

Direct Mouse Trauma/Burn Model of Heterotopic Ossification
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Multifocal adamantinoma simulating traumatic pathology on bone scanning.

Muhammad Babar Imran1, Muhammad Naeem

  • 1Punjab Institute of Nuclear Medicine, Jail Road, Adjacent PMC/CPSP Regional Office, Faisalabad, Pakistan. muhammadbabarimran@yahoo.com

Rheumatology International
|July 29, 2010
PubMed
Summary

Multifocal adamantinoma can mimic stress fractures in active patients. This rare bone tumor may present with lesions in unusual locations like the rib cage, not just the fibula.

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Area of Science:

  • Orthopedics
  • Oncology
  • Radiology

Background:

  • Adamantinoma is a rare, low-grade malignant bone tumor typically arising in the diaphysis of long bones.
  • It often affects young adults and can present with vague symptoms, leading to diagnostic challenges.

Observation:

  • A physically active young patient presented with right leg pain, initially suspected to be a stress fracture based on plain radiographs and bone scans.
  • Further investigations, including repeat imaging and histopathology, revealed multifocal adamantinoma.

Findings:

  • The adamantinoma lesions mimicked stress fractures on initial imaging.
  • A second lesion was found in the rib cage, challenging the typical understanding of adamantinoma metastasis to adjacent bones like the fibula.

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Last Updated: Jun 10, 2026

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Implications:

  • Physicians should maintain a broad differential diagnosis for leg pain, especially when treatment for suspected conditions like stress fractures is ineffective.
  • Tibial adamantinoma should be considered in the differential diagnosis of stress fractures, even with atypical presentations.
  • The possibility of non-contiguous, distant second lesions in adamantinoma requires consideration in staging and treatment planning.