Grade IA. A 20-year-old woman. A lobulated, sharply marginated geographic tumor is observed in the medial distal metaphysis of the femur. There is no penetration of cortex; a sclerotic rim is observed (solid arrow). The contour of the cortex is normal (no expanded shell, dashed arrow). This is the combination of descriptors that leads to assignment of Lodwick growth grade IA. The appearance is considered typical for non-ossifying fibroma (NOF); a histological diagnosis is not warranted in such a case [25]