Fig. 1

Patient 1: pre denosumab, a frontal plain radiograph shows a lytic Campanacci grade 2 distal radial GCTB with mild expansion and cortical thinning (arrow). Post denosumab at 2 months, b frontal plain radiograph demonstrates sclerosis of the tumour margin (arrows) and radial articular surface. There is mild modeling deformity of the radial articular surface and moderate internal matrix osteosclerosis. Post surgical, c frontal plain radiograph 1 week post surgical curettage, cementoplasty and internal fixation shows lucency of the peripheral tumour cavity (arrows) and d 2 years post surgery with progressive infilling of the lesion with osteosclerosis around the cement despite no post operative denosumab therapy (arrows)