Imaging of benign fibular tumours and their mimics

The fibula is a none-weight bearing, gracile bone that contributes to stability of the ankle and knee by acting as a site for tendon and ligament attachments. The fibula accounts for 2.5% of primary bone tumours. Benign tumours may have an atypical, aggressive appearance in the fibula. A brief discussion of the workup and management of fibular lesions is provided, followed by a discussion of individual primary benign fibular tumours and their mimics, both benign and malignant. To avoid compromising limb salvage surgery, image-guided biopsy of fibular lesions must be planned with the referring orthopaedic oncologist. The biopsy tract should be the shortest route, without violating more than 1 compartment, and should be as far as possible from the main neurovascular bundle. A proximal to mid-fibular lesion should be targeted with an approach traversing the peroneal musculature. To avoid ankle joint contamination,a distal fibular lesion is targeted with a direct lateral approach. (author)