Radiographic Signs:Patterns Of Bone Destuction Flashcards
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
Category of geographic lesion:
Well defined margin w/ sclerotic rim
Short zone of transition
Benign
1A
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
Category of Geographic lesion:
Well defined margin w/o sclerotic rim
More aggressive lesions > 1A
Wider transitional zone at the margin >1A
Benign
1B
Prime example cause of 1B geographic lesion
Osteomyelitis
Category of geographic lesion:
Ill-defined margin
Wide zone of transition
Aggressive, often malignant`
1C
When examining the x-ray above, need to know ALAS “a foxism”
Age
Location
Appearance
Symptom
When internal matrix has the same density as the medullary cavity
Isodense
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
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
Causes of Lesions:
No respect for anything (ie. Joints) unlike tumors
Does not stop at subchondral bone, would continue into joints
Osteomyelitis-Bone infection
What are the main destroyers of bone?
Infection and tumor
What ways do destructive bone lesions occur?
Replacement of bone with tissue or fluid
Removed by lytic enzymes
T/F: Infections can replace bone with tissue or fluid and remove bone by lytic enzyme activity.
True
What is the minimum loss of bone required to see on plain film?
30%
50% in the spine
What is the minimum loss required to see on MRI?
1-2%
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
What is the classic cause of punched out lesion?
Multiple Myeloma
Appearance of punched-out lesions in the skull?
Scattered
usually of uniform size
T/F: Punched-out lesions are usually part of myeltomatosis, which is wide spread loss of bone density
True
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
Cause of Moth eaten
Multiple Myeloma Metastasis Lymphoma Ewing's sarcoma Osteomyelitis Osterolytic sarcoma
Most common 1* bone malignancy
Multiple myeloma
Primary lymph malignancy that spreads to bone but rarely starts in
bone.
Lymphoma
