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Radiology
Skeletal “don’t Touch” Lesions
Built from Fundamentals of Diagnostic Radiology
What’s inside
4 sections · 62 slides
Overview
- What a “don’t touch” lesion is
- Why a differential list hurts here
- Why a biopsy can mislead
- How a harmless lesion gets overtreated
- Three categories of “don’t touch” lesions
Posttraumatic Lesions
Injuries and their healing response can mimic aggressive disease on film
- Myositis ossificans
- Myositis ossificans vs its malignant mimic
- Myositis ossificans of the femur
- Osteogenic sarcoma: the mimic to exclude
- MRI can mislead in myositis ossificans
- Myositis ossificans of the humerus: radiograph, MRI, CT
- Myositis ossificans: peripheral calcification on CT
- Avulsion injury
- Avulsion injury at the ischial tuberosity
- Avulsion with a Codman triangle of periostitis
- Why healing tissue looks malignant
- Cortical desmoid
- Cortical desmoid at the posterior distal femur
- Healed cortical desmoid: a well-defined defect
- Cortical desmoid on knee MRI
- Geodes: cysts beside an arthritic joint
- Geode in the shoulder
- Geode of the femoral head
- Discogenic vertebral sclerosis
- Discogenic vertebral sclerosis at L4
- Reading discogenic sclerosis
- Fracture mimicking a bone tumor
- Fracture mimicking osteosarcoma at the knee
- Pseudodislocation of the shoulder
- Pseudodislocation of the shoulder
- Pseudodislocation: finding the fracture
Normal Variants
Normal anatomy that can be mistaken for a lesion on imaging
- Dorsal defect of the patella
- Dorsal defect of the patella on AP and sunrise views
- Dorsal defect of the patella on MRI
- Pseudocyst of the humerus
- Pseudocyst of the humerus: why biopsies fail
- Pseudocyst of the humerus
- Os odontoideum
- Recognizing os odontoideum
- Os odontoideum on flexion and extension views
Obviously Benign Lesions
Real lesions to diagnose on imaging and leave alone
- Benign lesions the radiologist should own
- Nonossifying fibroma (NOF)
- Nonossifying fibroma of the fibula
- How a nonossifying fibroma heals
- Healing nonossifying fibroma of the proximal tibia
- Large nonossifying fibromas and fracture
- Large nonossifying fibroma of the tibia
- Bone islands and giant bone islands
- Giant bone island in the iliac wing
- Unicameral bone cyst in the calcaneus
- Unicameral bone cyst of the calcaneus
- Pseudotumor of the calcaneus
- Pseudocyst (pseudotumor) of the calcaneus
- Bone infarction: early changes
- Early bone infarct in the distal femur and proximal tibia
- MRI can spare a biopsy in infarction
- Bone infarct on radiograph and MRI
- Takeaways: when to leave a lesion alone
- Don’t touch lesion families
- Suggested Readings
- Suggested Readings
- Brant and Helms' Fundamentals of Diagnostic Radiology