Bone tumours
The basic principles about how an osseous lesion on x-ray should be evaluated and described.
Table of contents
- Indication / technique
- Normale Anatomy
- Checklist -Overview
- Checklist - Age & Location
- Checklist - Aspect Lesion
- Checklist - Periosteal Reactions
- Checklist - Soft Tissue & Solitary/Multiple
- Pathology - General
- Bone metastases
- Chondroid tumours
- Osteoid tumours
- Fibrous Bone Lesions
- Cystic Bone Lesions
- Giant Cell Tumour of Bone
- Paget Disease
- Multiple Myeloma
Checklist
When assessing an osseous lesion, it is important to consider the following eight aspects, in order to arrive at a sound (differential) diagnosis. Each aspect will be discussed further below.
The eight-step plan (fig. 4):
- What is the age/medical history of the patient? Clinical picture? (e.g. pain?)
- What is the location in the skeleton? (In which bone? epiphysis/metaphysis/diaphysis? Which bone layer? (= location transversely))
- Is it a sclerotic, lytic or mixed sclerotic/lytic lesion?
- Are matrix calcifications present? If so, what type?
- What is the pattern of destruction?
- Is there a periosteal reaction?
- Is there evidence of growth into the soft tissue?
- Is it a solitary lesion or are there multiple lesions?
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Literature: sources and author
Text
drs. A. van der Plas (MSK radiologist Maastricht UMC+)
With special thanks to:
drs. W. Huijgen (MSK radiologist HagaZiekenhuis Den Haag)
Illustrations
drs. A. van der Plas (MSK radiologist Maastricht UMC+)
Sources:
- A.M. Davies et al. Imaging of Bone Tumors and Tumor-Like Lesions (2009)
- A. Franchi; Epidemiology and classification of bone tumors. Clin Cases Miner Bone Metab. 2012.
21/10/2018
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