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Radiology

Skeletal “don’t Touch” Lesions

Built from Fundamentals of Diagnostic Radiology

The first 25 slides of Skeletal “don’t Touch” Lesions
The first 25 slides, exactly as they appear. The full deck has 62 content slides.

What’s inside

4 sections · 62 slides

  1. 01

    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

    5 slides

  2. 02

    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

    26 slides

  3. 03

    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

    9 slides

  4. 04

    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

    22 slides