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ROENTGEN SIGNS OF BONE DISEASES (PATTERNS OF BONE DESTRUCTION (OSTEO LYTIC…
ROENTGEN SIGNS OF BONE DISEASES
LESION ANALYSIS
SIZE
long axis, short axis
MARGINATION
poorly defined = aggressive; well defined = benign
CORTICAL INTEGRITY
THINNING
focal = medullary, diffuse = osteoporosis
THICKENING
physiological (Wolff's law), pathological e.g. Paget's fx with bowing deformity
EXPANSION
soap bubbly
DESTRUCTION / BREAK THROUGH
lytic destruction, aggressive
DISCONTINUITY / INTERRUPTION
fx
SYSTEMS INVOLVED
PATTERNS OF BONE DESTRUCTION
OSTEO LYTIC / OSEO LUCENT
aggressive vs benign
GEOGRAPHIC
well defined, clearly demarcated
MOTH EATEN
aggressive, focal, lytic, ill-defined
PERMEATIVE
aggressive, tumour
OSTEOBLASTIC VS SCLEROTIC
aggressive vs benign
MATRIX
soft tissue
FAT
CARTILAGE
lucent / lytic; stippled, flocculent, arc & ring
OSSEOUS
lucent, sclerotic, mixed, cortical bone island (enostoma)
FIBROUS
loose trabecular pattern
CYSTIC
not true tissue-based division
PERIOSTEAL RESPONSE
2 LAYERS
outer fibrous, inner layer
REACTION WHEN PUSHED AWAY FROM BONE
SOLID
single layer, benign, slow growing lesion
LAMINATED
onion skin, >1 layer, aggressive, faster process
SPICULATED
mc Ewing sarcoma - hair on end, sunburst, aggressive
CODMAN TRIANGLE
aggressive
SOFT TISSUE CHANGES
PRIMARY
mass-like regions: water / fat density, Ca++, ossification, air
SECONDARY
fat pad displacement