Radiographic Signs:Patterns Of Bone Destuction Flashcards Preview

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Flashcards in Radiographic Signs:Patterns Of Bone Destuction Deck (31)
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1

What are the various features of geographic lesions?

Centric or Eccentric
Expansile or Non expansile
Compartment or non-compartment
Speckled or radiolucent or
Isodense
well or ill-defined
Thin or thick sclerotic margin
Benign or malignant

2

Category of geographic lesion:

Well defined margin w/ sclerotic rim

Short zone of transition

Benign

1A

3

Bone lesion:

Slow growing and benign (can spread)

Larger > 1cm in size

Zone of transition is an indicator of its aggressiveness

Base lesion is radiolucent area lesion

Geographic

4

Category of Geographic lesion:

Well defined margin w/o sclerotic rim

More aggressive lesions > 1A

Wider transitional zone at the margin >1A

Benign

1B

5

Prime example cause of 1B geographic lesion

Osteomyelitis

6

Category of geographic lesion:

Ill-defined margin

Wide zone of transition

Aggressive, often malignant`

1C

7

When examining the x-ray above, need to know ALAS “a foxism”

Age

Location
Appearance

Symptom

8

When internal matrix has the same density as the medullary cavity

Isodense

9

Causes of Lesions:

Benign or malignant, are common causes of Geographic Lesion

Can destroy right up to the articular margin, but will not touch the joint
- subarticular

Tumors

10

Causes of Lesions:

(can be very dangerous)- full of plasma fluid (as opposed to cells)

Can destroy right up to the articular margin, but will not touch the joint
- subarticular

Tumor-like lesions

11

Causes of Lesions:

No respect for anything (ie. Joints) unlike tumors

Does not stop at subchondral bone, would continue into joints

Osteomyelitis-Bone infection

12

What are the main destroyers of bone?

Infection and tumor

13

What ways do destructive bone lesions occur?

Replacement of bone with tissue or fluid

Removed by lytic enzymes

14

T/F: Infections can replace bone with tissue or fluid and remove bone by lytic enzyme activity.

True

15

What is the minimum loss of bone required to see on plain film?

30%

50% in the spine

16

What is the minimum loss required to see on MRI?

1-2%

17

Bone lesion:

Individual lesions <1cm

Well defined with NO sclerotic margin (usually considered 1B)

Usually in flat bones, especially in cranial fault. (can be in spine)

Punched-out

18

What is the classic cause of punched out lesion?

Multiple Myeloma

19

Appearance of punched-out lesions in the skull?

Scattered

usually of uniform size

20

T/F: Punched-out lesions are usually part of myeltomatosis, which is wide spread loss of bone density

True

21

Bone Lesion:

Holes 2-5mm

Malignant-rapid growth

Ragged border/wide zone of transition

May be benign (Osteomyelitis) or malignant (Osteosarcoma)

Freq. coexist w/ permeative

Moth eaten

22

Cause of Moth eaten

Multiple Myeloma
Metastasis
Lymphoma
Ewing's sarcoma
Osteomyelitis
Osterolytic sarcoma

23

Most common 1* bone malignancy

Multiple myeloma

24

Primary lymph malignancy that spreads to bone but rarely starts in
bone.

Lymphoma

25

Primary bone malignancy classified as a round cell malignancy

4th most common primary bone malignancy

Primarily in children – 1st most common in first decade

Usually permeative lesion

Ewing's sarcoma

26

Moth eaten and permeative bone lesion has to affect the cortex to be seen on film.

How will the cortex appear?

The cortex will be thinned and radiolucent

27

Bone Lesion:
<1mm in size

Ill-defined

Worm holes small, tiny holes

Wide zone of transition with fine margins

Localized bone pain

Occurs in diaphysis

Permeative Osteolysis

28

In which category of bone lesion will the pt have bone pain?

Moth eaten

Permeative

29

Causes of permeative lesions

Lymphoma

Ewing's**

Multiple Myeloma

Osteomyelitis

Neuroblastoma(Metastatic

Osteolytic sarcoma

30

This cause of moth eaten and permeative lesions, comes from the adrenal glands, occurs 80% in children under 5 with a strong tendency to metastasize to bone

Neuroblastoma (METs)