Fibrous Dysplasia — ORE Part 1 MCQ

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ModerateOral PathologyFibrous DysplasiaORE Part 1

A 14-year-old patient presents with a unilateral bony swelling of the mandible causing facial asymmetry. Radiographs show a ground-glass radiopacity with loss of the normal trabecular pattern. What is the most likely diagnosis?

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Correct answer: C — Fibrous dysplasia

The answer is C (Fibrous dysplasia). The unilateral ground-glass radiopacity with loss of normal trabecular pattern is the classic radiographic presentation of monostotic fibrous dysplasia. The age of 14 is appropriate for FD to manifest. Cherubism (option D) is a crucial distractor—it is also a benign fibro-osseous lesion—but it is fundamentally distinguished by being bilateral and symmetric, whereas this case is unilateral. Cherubism also typically appears by age 7, not at 14. Ossifying fibroma (option E) can be unilateral and occur at this age but usually has more well-defined borders and a different radiographic character. Paget disease (option B) and osteosarcoma (option C) are age-inappropriate or too aggressive for this presentation.

Reference: Kochanowski NE, Badry MS, Abdelkarim AZ, et al. Radiographic Diagnosis of Fibrous Dysplasia in Maxilla. Cureus. 2018;10(8):e3127. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6181250/; Burke AB, Collins MT, Boyce AM. Fibrous dysplasia of bone: craniofacial and dental implications. Oral Dis. 2017;23(6):697–708.