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1、2010/10/16BoneTumors-DifferentialdiagnosisTheRadiologyAssistantBoneTumors-DifferentialdiagnosisbyHenkJanvanderWoudeandRobinSmithuisRadiologydepartmentoftheOnzeLieveVrouweGasthuis,AmsterdamandtheRijnlandhospital,Leiderdorp,theNetherlandsSystematicApproachPublicationd
2、ate:10-4-2010ZoneoftransitionAgeInthisarticlewewilldiscussasystematicapproachtoPeriostealreactionthedifferentialdiagnosisofbonetumorsandtumor-Corticaldestructionlikelesions.Location:epiphysis-metaphysis-diaphysisThedifferentialdiagnosismostlydependsontheLocation:cen
3、tric-eccentric-juxtacorticalreviewoftheconventionalradiographsandtheageofMatrixthepatient.PolyostoticormultiplelesionsBonetumorsinthespineAbbreviationsused:BonetumorsinthefootABC=AneurysmalbonecystCMF=ChondromyxoidfibromaPrintingofthearticleEG=EosinophilicGranulomaG
4、CT=GiantcelltumourFD=FibrousdysplasiaHPT=HyperparathyroidismwithBrowntumorNOF=NonOssifyingFibromaSBC=SimpleBoneCystSystematicApproachThemostimportantdeterminatorsintheanalysisofapotentialbonetumorare:1.ThemorphologyofthebonelesiononaplainradiographWell-definedosteol
5、yticill-definedosteolyticSclerotic2.TheageofthepatientItisimportanttorealizethattheplainradiographisthemostusefulexaminationfordifferentiatingtheselesions.CTandMRIareonlyhelpfulinselectedcases.Inthisarticletherearelinkstootherarticlesaboutbonetumors.well-definedoste
6、olyticbonetumorsill-definedosteolyticbonetumorsBonetumorsA-GMostbonetumorsareosteolytic.Themostreliableindicatorindeterminingwhethertheselesionsarebenignormalignantisthezoneoftransitionbetweenthelesionandtheadjacentnormalbone(1).Oncewehavedecidedwhetherabonelesionis
7、scleroticorosteolyticandwhetherithasawell-definedorill-definedmargins,thenextquestionshouldbe:howoldisthepatient?Ageisthemostimportantclinicalclue.Finallyothercluesneedtobeconsidered,suchasalesion’slocalizationwithintheskeletonandwithinthebone,anyperiostealrea
8、ction,corticaldestruction,matrixcalcifications,etc.radiologyassistant.nl/…/494e15cbf…1/102010/10/16BoneTumors-DifferentialdiagnosisIntheta
