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Bone tumor mimickers: A pictorial essay.

Mhuircheartaigh JN, Lin YC, Wu JS - Indian J Radiol Imaging (2014)

Bottom Line: These bone tumor mimickers can include numerous normal anatomic variants and non-neoplastic processes.It is important for the radiologist and clinician to be aware of these bone tumor mimickers and understand the characteristic features which allow discrimination between them and true neoplasms in order to avoid unnecessary additional workup.Knowing which lesions to leave alone or which ones require workup can prevent misdiagnosis and reduce patient anxiety.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States.

ABSTRACT
Focal lesions in bone are very common and many of these lesions are not bone tumors. These bone tumor mimickers can include numerous normal anatomic variants and non-neoplastic processes. Many of these tumor mimickers can be left alone, while others can be due to a significant disease process. It is important for the radiologist and clinician to be aware of these bone tumor mimickers and understand the characteristic features which allow discrimination between them and true neoplasms in order to avoid unnecessary additional workup. Knowing which lesions to leave alone or which ones require workup can prevent misdiagnosis and reduce patient anxiety.

No MeSH data available.


Related in: MedlinePlus

Stress fracture. A 68 year old female with right hip and thigh pain. (A) AP radiograph of the hip shows cortical thickening (arrow) in the lateral aspect of tibial shaft (B) Coronal and (C) axial CT images demonstrate a linear fracture line (arrows) within the cortical thickening
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Figure 11: Stress fracture. A 68 year old female with right hip and thigh pain. (A) AP radiograph of the hip shows cortical thickening (arrow) in the lateral aspect of tibial shaft (B) Coronal and (C) axial CT images demonstrate a linear fracture line (arrows) within the cortical thickening

Mentions: Stress fractures may be related to fatigue, when excessive repetitive force is applied to a normal bone, or insufficiency, when normal stress is applied to abnormal bone such as in osteoporosis or Paget's disease. Common sites for stress fractures include the metatarsals, tarsals, and tibia.[21] Initially, stress fractures may not be visible on radiographs and are better detected on technetium-99 m pyrophosphate bone scintigraphy (bone scan) or MRI [Figure 11]. With time, periosteal reaction and cortical resorption may be seen. A fracture line may be visible on radiographs, but could be better seen on computed tomography (CT). The fracture line is usually perpendicular to the cortex, and vertically oriented fractures can be difficult to detect. Radiographic features of stress fracture in the tibia can resemble a soleal line or osteoid osteoma, but can be differentiated from one another on CT [Figure 12]. Moreover, if the periosteal reaction appears aggressive, it can mimic infection or an aggressive tumor.[22] The presence of a fracture line, lack of a soft tissue mass, and evidence of healing on follow-up studies should help distinguish stress fractures from other entities.


Bone tumor mimickers: A pictorial essay.

Mhuircheartaigh JN, Lin YC, Wu JS - Indian J Radiol Imaging (2014)

Stress fracture. A 68 year old female with right hip and thigh pain. (A) AP radiograph of the hip shows cortical thickening (arrow) in the lateral aspect of tibial shaft (B) Coronal and (C) axial CT images demonstrate a linear fracture line (arrows) within the cortical thickening
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4126137&req=5

Figure 11: Stress fracture. A 68 year old female with right hip and thigh pain. (A) AP radiograph of the hip shows cortical thickening (arrow) in the lateral aspect of tibial shaft (B) Coronal and (C) axial CT images demonstrate a linear fracture line (arrows) within the cortical thickening
Mentions: Stress fractures may be related to fatigue, when excessive repetitive force is applied to a normal bone, or insufficiency, when normal stress is applied to abnormal bone such as in osteoporosis or Paget's disease. Common sites for stress fractures include the metatarsals, tarsals, and tibia.[21] Initially, stress fractures may not be visible on radiographs and are better detected on technetium-99 m pyrophosphate bone scintigraphy (bone scan) or MRI [Figure 11]. With time, periosteal reaction and cortical resorption may be seen. A fracture line may be visible on radiographs, but could be better seen on computed tomography (CT). The fracture line is usually perpendicular to the cortex, and vertically oriented fractures can be difficult to detect. Radiographic features of stress fracture in the tibia can resemble a soleal line or osteoid osteoma, but can be differentiated from one another on CT [Figure 12]. Moreover, if the periosteal reaction appears aggressive, it can mimic infection or an aggressive tumor.[22] The presence of a fracture line, lack of a soft tissue mass, and evidence of healing on follow-up studies should help distinguish stress fractures from other entities.

Bottom Line: These bone tumor mimickers can include numerous normal anatomic variants and non-neoplastic processes.It is important for the radiologist and clinician to be aware of these bone tumor mimickers and understand the characteristic features which allow discrimination between them and true neoplasms in order to avoid unnecessary additional workup.Knowing which lesions to leave alone or which ones require workup can prevent misdiagnosis and reduce patient anxiety.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States.

ABSTRACT
Focal lesions in bone are very common and many of these lesions are not bone tumors. These bone tumor mimickers can include numerous normal anatomic variants and non-neoplastic processes. Many of these tumor mimickers can be left alone, while others can be due to a significant disease process. It is important for the radiologist and clinician to be aware of these bone tumor mimickers and understand the characteristic features which allow discrimination between them and true neoplasms in order to avoid unnecessary additional workup. Knowing which lesions to leave alone or which ones require workup can prevent misdiagnosis and reduce patient anxiety.

No MeSH data available.


Related in: MedlinePlus