2. Clues by Appearance of Lesion
Clues by Location of Lesion
Clues by Density of Lesion
Other Clues
3. Clues by Appearance of Lesion
Patterns of Bone Destruction
Periosteal Reactions
Tumor Matrix
Expansile Lesions of Bone
4. Clues by Appearance of Lesion
Patterns of Bone Destruction
Geographic
Moth-eaten
Permeative
5. Geographic Bone Destruction
Destructive lesion with sharply defined border
Implies a less-aggressive, more slow-growing, benign
process
Narrow transition zone
6. Patterns of Bone Destruction
Geographic
Moth-eaten
Permeative
Non-ossifying fibroma
11. Permeative Bone Destruction
Ill-defined lesion with multiple “worm-holes”
Spreads through marrow space
Wide transition zone
Implies an aggressive malignancy
Round-cell lesions
12. Patterns of Bone Destruction
Geographic
Moth-eaten
Permeative
Leukemia
26. Expansile Lesions of Bone
•
•
•
•
•
•
Multiple myeloma
Mets
Brown tumor
Enchondroma
Aneurysmal bone cyst
Fibrous dysplasia
27. Expansile Lesions of Bone
Multiple
myeloma
Mets
Brown tumor
Enchondroma
Aneurysmal bone cyst
Fibrous dysplasia
28. Expansile Lesions of Bone
Multiple myeloma
Mets
Brown tumor
Enchondroma
Aneurysmal bone
cyst
Fibrous dysplasia
Renal cell carcinoma
29. Expansile Lesions of Bone
Multiple myeloma
Mets
Brown tumor
Enchondroma
Aneurysmal bone
cyst
Fibrous dysplasia
30. Expansile Lesions of Bone
Multiple myeloma
Mets
Brown tumor
Enchondroma
Aneurysmal bone
cyst
Fibrous dysplasia
31. Expansile Lesions of Bone
Multiple myeloma
Mets
Brown tumor
Enchondroma
Aneurysmal bone
cyst
Fibrous dysplasia
32. Expansile Lesions of Bone
Multiple myeloma
Mets
Brown tumor
Enchondroma
Aneurysmal bone
cyst
Fibrous dysplasia
33. Clues by Location of Lesion
•
•
•
•
In the Transverse Plane
In the Longitudinal Plane
Characteristic Locations by tumors
Characteristic Tumors by Body Site
– Pelvic Lesions
– Expansile Rib Lesions
– Lesions of the Spine
42. Clues by Density of Lesion
Sclerotic Cortical Lesions
Lytic Lesions in Children
Lytic Lesions in Adults
Blastic Lesions in Children
Blastic Lesions in Adults
56. Soft Tissue Extension
Usually implies malignancy
More likely to form discrete soft tissue mass
Benign conditions with soft tissue extension
Osteomyelitis
Usually infiltration of fat