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Radiology

Benign Lucent Bone Lesions

Built from Fundamentals of Diagnostic Radiology

The first 25 slides of Benign Lucent Bone Lesions
The first 25 slides, exactly as they appear. The full deck has 98 content slides.

What’s inside

5 sections · 98 slides

  1. 01

    Overview

    • Benign Lucent Bone Lesions

    1 slide

  2. 02

    Approaching a lucent bone lesion

    Confirm the lesion is benign, then let FEGNOMASHIC drive a short, accurate list

    • How to approach a benign lucent lesion
    • A common skeletal finding
    • Pattern recognition and its limits
    • A mnemonic makes the list recallable
    • FEGNOMASHIC expands — F through O
    • FEGNOMASHIC expands — M through C
    • Discriminators for benign lucent bone lesions
    • Discriminators for benign lucent bone lesions (continued)

    9 slides

  3. 03

    The fifteen FEGNOMASHIC lesions

    What each lesion looks like, and the one or two keys that set it apart

    • Fibrous dysplasia — the great mimic
    • Fibrous dysplasia — where it grows
    • Fibrous dysplasia of the pelvis and proximal femurs
    • Fibrous dysplasia of the right femur and ilium
    • Monostotic fibrous dysplasia of the femoral neck
    • Fibrous dysplasia of the posterior ribs and spine
    • Polyostotic fibrous dysplasia of the radius in a child
    • Fibrous dysplasia — tibia look-alikes and syndromes
    • Adamantinoma of the tibial midshaft
    • Enchondroma — the cartilage lesion
    • Enchondroma of the phalanges with pathologic fracture
    • Enchondroma of the distal femur with chondroid matrix
    • Enchondroma — infarct, sarcoma, and syndromes
    • Bone infarcts of the distal femurs
    • Ollier disease: multiple enchondromas of the hand
    • Maffucci syndrome: enchondromas and phleboliths
    • Eosinophilic granuloma — protean and young
    • Eosinophilic granuloma of the mid-femur
    • Polyostotic eosinophilic granuloma of the pelvis
    • Eosinophilic granuloma — sequestrum and mimicry
    • Eosinophilic granuloma with a bony sequestrum
    • Giant cell tumor — nature and outcome
    • Four criteria for giant cell tumor
    • Giant cell tumor — applying the rules
    • Giant cell tumor of the distal femur
    • Giant cell tumor of the greater trochanter
    • Giant cell tumor of the iliac wing
    • Nonossifying fibroma — the most common lesion
    • Fibrous cortical defect of the medial tibia
    • Nonossifying fibroma of the distal tibia
    • Nonossifying fibroma — how to recognize it
    • Nonossifying fibroma of the distal fibula
    • Nonossifying fibroma: apparent cortical destruction on CT
    • Nonossifying fibroma — healing and pitfalls
    • Healing nonossifying fibroma of the proximal humerus
    • Large nonossifying fibroma of the distal femur
    • Osteoblastoma — rare ABC mimic
    • Osteoblastoma of the T12 posterior elements
    • Metastatic disease — a benign look is possible
    • Renal metastasis with a benign appearance
    • Expansile renal cell metastasis of the radius
    • Myeloma and plasmacytoma
    • Multiple myeloma: permeative femur and skull lesions
    • Plasmacytoma of the ilium
    • Plasmacytoma of L5 with mini-brain appearance
    • Aneurysmal bone cyst — expansile by name
    • Aneurysmal bone cyst of the distal femur
    • Aneurysmal bone cyst of the ulnar midshaft
    • Aneurysmal bone cyst with fluid-fluid levels
    • Solitary bone cyst — always central
    • Solitary bone cyst of the proximal femur
    • Solitary bone cyst — fallen fragment and sites
    • Solitary bone cyst of the proximal humerus with fallen fragment sign
    • Solitary bone cyst of the calcaneus
    • Brown tumors of hyperparathyroidism
    • Brown tumors of the hand in hyperparathyroidism
    • Cystic angiomatosis — multiple hemangiomas
    • Cystic angiomatosis of the pelvis and femurs
    • Osteomyelitis — no reliable exclusion
    • Brodie abscess of the proximal humerus
    • Osteomyelitis with a bony sequestrum
    • Chondroblastoma — epiphyseal and young
    • Chondroblastoma of the greater tuberosity
    • Geode — a benign epiphyseal mimic
    • Geode of the proximal humerus with degenerative disease
    • Chondromyxoid fibroma — NOF look-alike
    • Chondromyxoid fibroma of the distal tibia

    67 slides

  4. 04

    Narrowing the differential

    Age, site, pain, and lesion number shrink FEGNOMASHIC to a short list

    • Keys that narrow the list
    • Narrowing by age
    • Lesions in patients younger than 30 years of age
    • Automatics — mention them every time
    • Automatics
    • Pain and periostitis shorten the list
    • Lesions that have no pain or periostitis
    • Epiphyseal lesions
    • Epiphyseal lesions
    • Rib lesions — the FAME mnemonic
    • Differential for rib lesions (FAME)
    • Multiple lesions — the FEEMHI mnemonic
    • Multiple lesions (FEEMHI)
    • Findings that do not narrow the list
    • Calcified matrix — be careful

    15 slides

  5. 05

    Sclerotic look-alikes

    When a lucent lesion heals, it can become a sclerotic focus

    • When a lucent lesion heals into sclerosis
    • Healing nonossifying fibroma of the proximal tibia
    • Giant bone island of the supra-acetabular ilium
    • Summary — a working differential
    • References
    • Brant and Helms' Fundamentals of Diagnostic Radiology

    6 slides