ICD-10: M85.01

Fibrous dysplasia (monostotic) is a benign bone disorder characterized by the replacement of normal bone with fibrous tissue, leading to structural weakness and deformity. The ICD-10 code M85.01 specifically refers to cases where this condition affects a single bone, in this instance, the shoulder. Below is a detailed overview of the clinical presentation, signs, symptoms, and patient characteristics associated with this diagnosis.

Clinical Presentation

Overview of Fibrous Dysplasia

Fibrous dysplasia can occur in two forms: monostotic, affecting a single bone, and polyostotic, affecting multiple bones. Monostotic fibrous dysplasia is more common and often presents in the long bones, ribs, and facial bones, with the shoulder being a less frequent site of involvement.

Age of Onset

Fibrous dysplasia typically manifests in childhood or early adulthood, with most cases diagnosed between the ages of 5 and 15 years. However, it can remain asymptomatic and undiagnosed until adulthood, particularly in monostotic cases[1][2].

Signs and Symptoms

Common Symptoms

Patients with monostotic fibrous dysplasia of the shoulder may experience a variety of symptoms, including:

• Pain: Localized pain in the shoulder region is common, often described as dull or aching. Pain may worsen with activity or weight-bearing.
• Swelling: There may be noticeable swelling or a palpable mass over the affected area, which can be mistaken for other conditions.
• Limited Range of Motion: Patients may exhibit restricted movement in the shoulder joint due to pain or mechanical instability.
• Deformity: In some cases, deformity of the shoulder may occur as the fibrous tissue replaces normal bone, leading to asymmetry or abnormal contour.

Physical Examination Findings

During a physical examination, healthcare providers may observe:

• Tenderness over the affected shoulder.
• Decreased strength in shoulder movements.
• Possible crepitus (a grating sound) during shoulder motion, indicating joint involvement.

Patient Characteristics

Demographics

• Age: Most commonly diagnosed in children and young adults, with a peak incidence in the second decade of life.
• Gender: There is no significant gender predilection, although some studies suggest a slight female predominance[3].

Associated Conditions

Fibrous dysplasia can occur as an isolated condition or as part of syndromes such as McCune-Albright syndrome, which includes endocrine abnormalities and skin pigmentation changes. Patients with monostotic fibrous dysplasia may not exhibit these associated features, making the diagnosis more straightforward in isolated cases[4].

Risk Factors

While the exact cause of fibrous dysplasia is not fully understood, it is believed to be related to a mutation in the GNAS gene, which affects bone development. There are no known environmental risk factors, and the condition is not inherited in a traditional Mendelian fashion[5].

Conclusion

Fibrous dysplasia (monostotic) of the shoulder presents with a range of symptoms primarily related to pain, swelling, and limited mobility. It typically affects younger individuals and can lead to significant discomfort and functional impairment if not diagnosed and managed appropriately. Early recognition and treatment are crucial to prevent complications such as fractures or deformities associated with the weakened bone structure. If you suspect fibrous dysplasia, a thorough clinical evaluation, including imaging studies, is essential for accurate diagnosis and management.

References

1. ICD-10-CM Diagnosis Code M85.01 - Fibrous dysplasia (monostotic) [1].
2. ICD-10-CM Diagnosis Code M85.00 - Fibrous dysplasia (monostotic) [2].
3. Fibrous dysplasia of bone [3].
4. ICD-10 code M85.0 | Fibrous dysplasia (monostotic) [4].
5. 2025 ICD-10-CM Diagnosis Code M85.01 - ICD List [5].

Fibrous dysplasia is a bone disorder characterized by the replacement of normal bone with fibrous tissue, leading to structural weakness and deformity. The ICD-10 code M85.01 specifically refers to monostotic fibrous dysplasia affecting the shoulder. Below is a detailed clinical description and relevant information regarding this condition.

Clinical Description of Fibrous Dysplasia

Definition

Fibrous dysplasia is a benign skeletal disorder that occurs when normal bone is replaced by fibrous tissue, resulting in the formation of a mass that can weaken the bone structure. It can affect one bone (monostotic) or multiple bones (polyostotic). The monostotic form is more common and typically presents with fewer complications compared to the polyostotic variant.

Pathophysiology

The exact cause of fibrous dysplasia is linked to a mutation in the GNAS gene, which affects the signaling pathways that regulate bone growth and development. This mutation leads to the abnormal proliferation of fibrous tissue and the disruption of normal bone architecture. The condition can manifest at any age but is often diagnosed in adolescents and young adults.

Symptoms

Patients with monostotic fibrous dysplasia of the shoulder may experience:
- Localized pain: This can vary in intensity and may worsen with activity.
- Swelling: There may be noticeable swelling in the affected area.
- Deformity: In some cases, the shoulder may appear deformed due to the abnormal growth of fibrous tissue.
- Limited range of motion: Patients may find it difficult to move the shoulder normally due to pain or structural changes.

Diagnosis

Diagnosis typically involves:
- Imaging studies: X-rays, CT scans, or MRIs are used to visualize the affected bone and assess the extent of the dysplasia. X-rays may show a characteristic "ground-glass" appearance of the bone.
- Biopsy: In some cases, a biopsy may be performed to confirm the diagnosis and rule out other conditions.

Treatment

Management of monostotic fibrous dysplasia of the shoulder may include:
- Pain management: Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to alleviate pain.
- Physical therapy: This can help improve range of motion and strengthen surrounding muscles.
- Surgery: In cases where there is significant deformity or functional impairment, surgical intervention may be necessary to remove the fibrous tissue and stabilize the bone.

Prognosis

The prognosis for individuals with monostotic fibrous dysplasia is generally favorable, especially when the condition is diagnosed early and managed appropriately. Most patients can lead normal lives, although some may experience recurrent pain or complications related to the affected bone.

Conclusion

ICD-10 code M85.01 identifies monostotic fibrous dysplasia of the shoulder, a condition that can significantly impact a patient's quality of life due to pain and functional limitations. Early diagnosis and a tailored treatment approach are essential for managing symptoms and improving outcomes. Regular follow-up with healthcare providers is recommended to monitor the condition and address any emerging issues.

Fibrous dysplasia is a bone disorder characterized by the replacement of normal bone with fibrous tissue, leading to structural weakness and deformity. The ICD-10 code M85.01 specifically refers to monostotic fibrous dysplasia affecting the shoulder. Here, we will explore alternative names and related terms associated with this condition.

Alternative Names for Fibrous Dysplasia

1. Fibrous Dysplasia of Bone: This is a broader term that encompasses all forms of fibrous dysplasia, including monostotic and polyostotic types.
2. Monostotic Fibrous Dysplasia: This term specifically refers to fibrous dysplasia affecting a single bone, as opposed to multiple bones (polyostotic).
3. Fibrous Osteodystrophy: An older term that may be used interchangeably, though it is less common in modern medical terminology.
4. Café-au-lait Spots: While not a direct synonym, these skin manifestations are often associated with fibrous dysplasia, particularly in cases of polyostotic fibrous dysplasia.

Related Terms

1. Bone Lesions: Fibrous dysplasia is classified as a type of bone lesion, which can include various other conditions affecting bone integrity.
2. Skeletal Dysplasia: This term refers to a group of disorders characterized by abnormal bone and cartilage development, of which fibrous dysplasia is a part.
3. Osteitis Fibrosa Cystica: This term is sometimes used in the context of conditions that may present similarly to fibrous dysplasia, particularly in relation to hyperparathyroidism.
4. Paget's Disease of Bone: Although distinct, Paget's disease can present with similar symptoms and may be confused with fibrous dysplasia in some cases.

Conclusion

Understanding the alternative names and related terms for ICD-10 code M85.01 is essential for accurate diagnosis and communication in medical settings. While "fibrous dysplasia" remains the primary term, recognizing its variations and related conditions can enhance clarity in clinical discussions and documentation. If you have further questions or need more specific information, feel free to ask!

Fibrous dysplasia is a bone disorder characterized by the replacement of normal bone with fibrous tissue, leading to structural weakness and deformity. The ICD-10 code M85.01 specifically refers to monostotic fibrous dysplasia affecting the shoulder. To diagnose this condition, healthcare providers typically rely on a combination of clinical evaluation, imaging studies, and sometimes histological examination. Below are the key criteria used for diagnosis:

Clinical Evaluation

1. Patient History:
   - A thorough medical history is essential, including any symptoms such as pain, swelling, or deformity in the shoulder area. Patients may report a gradual onset of symptoms, which can sometimes be mistaken for other conditions.

2. Physical Examination:
   - A physical examination may reveal tenderness, swelling, or limited range of motion in the shoulder. The physician will assess for any visible deformities or abnormalities in the shoulder structure.

Imaging Studies

1. X-rays:
   - Initial imaging often involves X-rays, which may show characteristic features of fibrous dysplasia, such as a "ground-glass" appearance of the bone, cortical thinning, and possible expansion of the affected area.

2. MRI and CT Scans:
   - Magnetic Resonance Imaging (MRI) or Computed Tomography (CT) scans can provide more detailed images of the bone and surrounding soft tissues. These modalities help in assessing the extent of the lesion and any associated complications, such as fractures.

Histological Examination

1. Biopsy:
   - In some cases, a biopsy may be performed to obtain a tissue sample for histological analysis. The presence of fibrous tissue replacing normal bone, along with the absence of osteoblastic activity, can confirm the diagnosis of fibrous dysplasia.

Differential Diagnosis

1. Exclusion of Other Conditions:
   - It is crucial to differentiate fibrous dysplasia from other bone lesions, such as osteosarcoma or other benign tumors. This may involve additional imaging studies or laboratory tests to rule out other conditions.

Conclusion

The diagnosis of monostotic fibrous dysplasia of the shoulder (ICD-10 code M85.01) is based on a combination of clinical findings, imaging studies, and, when necessary, histological confirmation. Accurate diagnosis is essential for appropriate management and treatment planning, which may include monitoring, pain management, or surgical intervention in cases of significant deformity or functional impairment.

Fibrous dysplasia is a bone disorder characterized by the replacement of normal bone with fibrous tissue, leading to structural weakness and deformity. The ICD-10 code M85.01 specifically refers to monostotic fibrous dysplasia affecting the shoulder. Treatment approaches for this condition can vary based on the severity of symptoms, the extent of the disease, and the individual patient's needs.

Standard Treatment Approaches

1. Observation and Monitoring

For asymptomatic patients or those with mild symptoms, a conservative approach may be adopted. Regular monitoring through imaging studies (such as X-rays or MRIs) can help track the progression of the disease without immediate intervention. This approach is particularly common in pediatric cases, where the condition may stabilize or improve as the child grows.

2. Pain Management

Pain relief is a primary concern in managing fibrous dysplasia. Non-steroidal anti-inflammatory drugs (NSAIDs) are often prescribed to alleviate discomfort. In cases where pain is more severe or persistent, stronger analgesics or corticosteroids may be considered.

3. Physical Therapy

Physical therapy can be beneficial in improving function and strength in the affected shoulder. A tailored exercise program can help maintain mobility, reduce stiffness, and strengthen surrounding muscles, which may compensate for any weakness in the affected bone.

4. Surgical Intervention

Surgery may be indicated in cases where fibrous dysplasia leads to significant pain, deformity, or functional impairment. Surgical options include:

• Curettage and Bone Grafting: This procedure involves removing the fibrous tissue and filling the defect with bone graft material to promote normal bone healing and stability.
• Stabilization Procedures: In cases where the structural integrity of the shoulder is compromised, stabilization techniques such as the use of plates or screws may be necessary to support the bone during healing.

5. Bisphosphonates

In some cases, bisphosphonates, which are medications that help strengthen bone, may be used to manage pain and reduce the risk of fractures. These medications can inhibit the activity of osteoclasts, the cells responsible for bone resorption, thereby potentially stabilizing the affected area.

6. Regular Follow-Up

Ongoing follow-up with healthcare providers is essential to monitor the condition and adjust treatment plans as necessary. This may include periodic imaging and assessments to evaluate the effectiveness of the treatment and the need for any adjustments.

Conclusion

The management of monostotic fibrous dysplasia of the shoulder (ICD-10 code M85.01) typically involves a combination of conservative measures, pain management, physical therapy, and, when necessary, surgical intervention. Each treatment plan should be individualized based on the patient's specific symptoms and overall health. Regular monitoring and follow-up care are crucial to ensure optimal outcomes and to address any complications that may arise.