Sclerotic bone metastases typically present as radiodense bone lesions that are round/nodular with relatively well-defined margins 3. Sclerosis can also be reactive, e.g. Another approach to the differential diagnosis of sclerotic bone lesions is to use the mnemonic I VINDICATE, which means 'I clear myself from accusation'. Lumbar CT-HU has the highest pooled correlation (r 2 =0.6) with both spine DEXA and lowest skeletal t-score followed by lumbar CT-HU with hip DEXA (r 2 =0.5) and lumbar MRI with hip (r 2 =0.44) and spine (r 2 =0.41) DEXA. In this case, because of the increased uptake on bone scintigraphy, a follow-up MRI was recommended at 6 and 12 months. The differential diagnosis mostly depends on the review of the conventional radiographs and the age of the patient. Finally other clues need to be considered, such as a lesion's localization within the skeleton and within the bone, any periosteal reaction, cortical destruction, matrix calcifications, etc. Sclerotic means that the lesions are slow-growing changes to your bone that happen very gradually over time. Intense uptake on bone scintigraphy as we would expect in high grade chondrosarcoma. Because of the large dimensions with soft tissue extension on plain radiograph and axial T2-weighted MR image, a high grade chondrosarcoma was suspected. DD: juxtacortical chondrosarcoma, parosteal osteosarcoma. ADVERTISEMENT: Supporters see fewer/no ads. After an injury, different types of fluid can build up in a bone. If you can find evidence of subchondral collapse or the typical lucent/sclerotic appearance of the necrotic bone in the weight-bearing bone, then osteonecrosis becomes a much more likely diagnosis. (white arrows). Skeletal Radiol. Ossifications or calcifications can be present in variable amounts. In 8 of the 24 patients, 17 of 52 new sclerotic lesions (33%) had showed positive uptake on previous bone scans. Here images of a patient with prostate cancer. Macedo F, Ladeira K, Pinho F et al. Increased uptake on bone scan has been reported in bone islands, especially giant ones, but warrants imaging follow-up. At Henry Ford Orthopaedics in Chelsea our mission is to provide personalized treatment plans specific to each patient, to ensure the best possible outcome. What does it mean that a lesion is sclerotic? Bone scan shows no high activity, opposed to low-grade intraosseous osteosarcoma. 2021;216(4):1022-30. Gulati V, Chalian M, Yi J, Thakur U, Chhabra A. Sclerotic Bone Lesions Caused by Non-Infectious and Non-Neoplastic Diseases: A Review of the Imaging and Clinicopathologic Findings. Metastases must be included in the differential diagnosis of any bone lesion, whether well-defined or ill-defined osteolytic or sclerotic in age > 40. Here a lesion in the epiphysis, which was the result of post-traumatic osteonecrosis. Metastatic sclerotic bone lesions present in three typical patterns, focal, variegated, or diffuse based on the histological origin of the primary tumor. The sclerotic lesion in the humeral head could very well be a benign enchondroma based on the imaging findings. Click here for more examples of enchondromas. sclerosing osteomyelitis of Garr, aggressive features might require an oncological referral and/or biopsy 1, history of malignancy will almost always require additional imaging, follow-up or oncologic referral, high CT attenuation values might help in the differentiation of bone island from osteoblastic metastases 5 but attenuation values should not be used exclusively for the assessment of sclerotic bone lesions 6, Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Clin Orthop Relat Res. Distinguishing Untreated Osteoblastic Metastases From Enostoses Using CT Attenuation Measurements. In the cases in which the solitary sclerotic lesion has increased, uptake on bone scan, follow-up CT, or plain film imaging is recommended at 3-, 6-, and 12-month intervals. Azar A, Garner H, Rhodes N, Yarlagadda B, Wessell D. CT Attenuation Values Do Not Reliably Distinguish Benign Sclerotic Lesions From Osteoblastic Metastases in Patients Undergoing Bone Biopsy. A molecular classification has been also proposed. Donald Resnick, Mark J. Kransdorf. Sclerotic bone metastases can arise from several different primary malignancies including 1-3: mucinous adenocarcinoma of the gastrointestinal tract (e.g. Fibrous dysplasia, enchondromas, EG, Mets and myeloma, Hyperparathyroidism, Infection. Rapid growth of the mineralized mass is not uncommon. Sclerotic bone metastases. Incidentally discovered, benign lesions also called enostoses, which are islands of cortical bone located in the cancellous bone. When considering hyperparathyroidism, look for evidence of subperiosteal bone resorption. However, a specific density range has not been specified for those terms 1. Here an illustration of the most common sclerotic bone tumors. Radiologe. Bone and Joint Imaging. Differential Diagnosis of Diffuse Sclerotic Bone Lesions. The most common focal metastatic lesions originate from the breast (37%), lung (15%), kidney (6%), and thyroid (4%) 43. On the left three bone lesions with a narrow zone of transition. Case 2: sclerotic metastases from prostate cancer, Generalised increased bone density (mnemonic). Sclerotic bone lesions are rare; commonly affects the axial skeleton (pelvis, spine, skull, ribs) and the patients are often symptomatic as opposed to the patients with lytic lesions who rarely have any symptoms. Density measurements on CT scan revealed greater than 1,000 HU throughout the lesion. Osteoblastic metastatic disease (see Table 33.1): More often multiple with increased uptake on bone scan. Classic ground glass appearance of the bone. On the right T2-WI with FS of same patient.. A lumbar puncture (LP) is a diagnostic procedure used to obtain a sample of cerebrospinal fluid (CSF) to look for signs of infection or inflammation. Bone islands demonstrate uniformly low 105-118. The NK cell type is seen as a sheet of soft tissue in the nasal cavity with bone destruction and erosion without any sclerosis. Symptoms are usually absent, however, in adult patients with a chondroid lesion in a long bone, particularly of larger size, always consider low-grade chondrosarcoma. Occasionally slowly enlargement can be seen. Check for errors and try again. 5 Biopsy should be considered in atypical cases or in high-risk patients with primary malignancies associated with osteoblastic metastatic disease. Usually typical malignant features including permeative-motheaten pattern of destruction, irregular cortical destruction and aggressive (interrupted) periosteal reaction. RT @JMGardnerMD: 20 yo M w/ 5 cm lytic bone lesion in proximal tibia metaphysis, sharply demarcated w/ sclerotic rim. 1. 2014;71(1):39. In the table the most common sclerotic bone tumors and tumor-like lesions in different age-groups are presented. Park S, Lee I, Cho K et al. Ahuja S & Ernst H. Osteoblastic Bone Metastases in Medullary Thyroid Carcinoma. MRI of the sacrum: axial T1-weighted (T1w; Fig. Notice the lytic peripheral part with subtle calcifications. Imaging of skull vault tumors in adults: Author: Pons Escoda, Albert Naval Baudin, Pablo . Centrally there is an ill-defined osteolytic area. Azar A, Garner H, Rhodes N, Yarlagadda B, Wessell D. CT Attenuation Values Do Not Reliably Distinguish Benign Sclerotic Lesions From Osteoblastic Metastases in Patients Undergoing Bone Biopsy. Presentation: pain, mass, pathologic fracture. For example: Differential Diagnosis of Focal or Multifocal Sclerotic Bone Lesions. Click here for more examples of eosinophilic granuloma. In order to classify osteolytic lesions as well-defined or ill-defined, we need to look at the zone of transition between the lesion and the adjacent normal bone. Matching the degradation rate of the materials with neo bone formation remains a challenge for bone-repairing materials. MRI also may detect the nidus, combined with abundant bone marrow and soft tissue edema. In skeletally mature patients, GCTs begin in the metaphysics and extend deep to the subchondral bone plate of the articular surface. Less common: Fibrous dysplasia, Brown tumors of hyperparathyroidism, bone infarcts. Particularly chronic osteomyelitis may have a sclerotic appearance. Should be included in the differential diagnosis of young patient with multiple lucent lesions (Langerhans cell histiocytosis). Lippincott Williams & Wilkins. However, these lesions are often underreported, mainly because the subject is not well known to general radiologists who struggle with the imaging approach and disease entities. The zone of transition only applies to osteolytic lesions since sclerotic lesions usually have a narrow transition zone. Radiographic features that should raise the suspicion of malignant transformation on plain radiographs or CT include: Here the reactive sclerosis is the most obvious finding on the X-ray. Gadolinium is usually minimal or absent (see right image). Focal sclerotic bony lesions (mnemonic). The differential for multifocal lesions happens to be identical to that for focal lesions. Notice how easily MRI depicts these lesions. For the unexpected bone lesions, the distinguishing anatomic features and a generalized imaging approach will be reviewed for four frequently encountered scenarios: chondroid lesions, sclerotic bone lesions, osteolytic lesions, and areas of focal marrow abnormality. colon carcinoma, gastric carcinoma), ADVERTISEMENT: Supporters see fewer/no ads. AJR Am J Roentgenol. Sclerotic bone lesions caused by non-infectious and non-neoplastic diseases: a review of the imaging and clinicopathologic findings Sclerotic bone lesions caused by non-infectious and non-neoplastic diseases: a review of the imaging and clinicopathologic findings Authors Many lesions can be located in both or move from the metaphysis to the diaphysis during growth. Most commonly originate from prostate and breast cancer and less frequently from lung cancer, lymphoma or carcinoid. It grows primarily into the surrounding soft tissues, but may also infiltrate into the bone marrow. Some prefer to divide patients into two age groups: 30 years. 2, The primary utility of the bone scan is that if there is no increased uptake, sclerotic metastatic disease is highly unlikely; therefore, the lesion can be considered most likely a bone island and follow-up radiographic imaging obtained. MRI shows large tumor within the bone and permeative growth through the Haversian channels accompanied by a large soft tissue mass, which is barely visible on the X-ray. Hall F & Gore S. Osteosclerotic Myeloma Variants. The mnemonic I VINDICATE is a commonly used mnemonic for the differential diagnostis of any radiological lesion. Fibro-osseous lesion like fibrous dysplasia. The cortical bone and bone marrow compartment are not involved. Oncol Rev. The chondroid matrix is of a variable amount from almost absent to dens compact chondroid matrix. Radiographic or CT features that suggest malignancy: Use MRI with water-sensitive sequence (T2 FS) to determine cartilage cap thickness. Fibrous dysplasia can be monostotic or polyostotic. Imaging: Unable to process the form. Notice the homogeneous thickening of the cortical bone. Teaching Point: Metastasis is the most common malignant rib lesion. Osteoid matrix 2022;51(9):1743-64. Differentiating between a diaphyseal and a metaphyseal location is not always possible. Sclerotic bone lesions appear exclusively in middle aged black patients. Sarcoidosis is a multi-system disease with a range of . Diffuse bony sclerosis (mnemonic) Last revised by Joshua Yap on 28 Jun 2022 Edit article Citation, DOI & article data A mnemonic for remembering the causes of diffuse bony sclerosis is: 3 M's PROOF Mnemonic 3 M's PROOF M: malignancy metastases ( osteoblastic metastases) lymphoma leukemia M: myelofibrosis M: mastocytosis S: sickle cell disease These lesions usually regress spontaneously and may then become sclerotic. 1. Development in centrally located osteochondromas like the pelvis, hip and shoulder is most common. Concerning the above factors the differential diagnosis includes the following lesions 1-3: sclerotic bone metastasis: might be solitary because no others are present or have been imaged, infection: e.g. Reference article, Radiopaedia.org (Accessed on 02 Mar 2023) https://doi.org/10.53347/rID-21100, Mnemonic for focal sclerotic lesions (mnemonic). Amsterdam: Elsevier, 1993. Axial imaging for differentiation from Brodie abscess, osteoblastoma, stress fracture. O'Sullivan G, Carty F, Cronin C. Imaging of Bone Metastasis: An Update. Diagnostic brain imaging tests can assess bone fractures, structural problems, blood vessel abnormalities, and changes in brain metabolism. There are a number of other helpful findings you can look for that can help you to cone in on or away from specific entities in one of these differential lists. Surrounded by a prominent zone of reactive sclerosis due to a periosteal and endosteal reaction, which may obscure the central nidus. A juxtacortical chondrosarcoma has be considered in the differential diagnosis when a mineralized lesion adjacent to the cortical bone is seen. In this article we will discuss a systematic approach to the differential diagnosis of bone tumors and tumor-like lesions. Enchondroma, the most commonly encountered lesion of the phalanges. Fundamentals of Skeletal Radiology, second edition A Codman's triangle refers to an elevation of the periosteum away from the cortex, forming an angle where the elevated periosteum and bone come together. 9. 4 , 5 , 6. AJR 1995;164:573-580, Online teaching by the Musculoskeletal Radiology academic section of the University of Washington, by Theodore Miller March 2008 Radiology, 246, 662-674, by Laura M. Fayad, Satomi Kawamoto, Ihab R. Kamel, David A. Bluemke, John Eng, Frank J. Frassica and Elliot K. Fishman. In the active phase there is multilaminar periosteal reaction and bone and soft tissue edema. Reference article, Radiopaedia.org (Accessed on 02 Mar 2023) https://doi.org/10.53347/rID-22391. 6. Differential diagnosis In most cases of osteoid osteoma the radiographic appearance is determined by the reactive sclerosis. Scuba Certification; Private Scuba Lessons; Scuba Refresher for Certified Divers; Try Scuba Diving; Enriched Air Diver (Nitrox) 2016;207(2):362-8. We provide care in several areas of orthopedics, such as: hand and wrist care, foot and ankle care, and joint replacement. Typically a NOF presents as an eccentric well-defined lytic lesion, usually found as a coincidental finding. A popular mnemonic to help remember causes of focal sclerotic bony lesions is: Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Yes, it is possible to have a clear lumbar puncture and still have Multiple Sclerosis (MS). Halo of increased signal on T2 W images about the low signal central lesion is suggestive of metastatic disease. Many important signaling . Diffuse skeletal infarcts can be a common cause of diffuse skeletal sclerosis. Sclerosing bone dysplasias are skeletal abnormalities of varying severity with a wide range of radiologic, clinical, and genetic features. Brant WE, Helms CA. The benign type is seen in benign lesions such as benign tumors and following trauma. Prevalence of 3-5% in patients with hereditary multiple osteohondromas. When considering trauma as a cause for sclerotic lesions, remember to check and see if the areas involved are areas in the typical distribution for stress fractures. Localisation: femur, tibia, hands and feet, spine (arch). Small zone of transitionA small zone of transition results in a sharp, well-defined border and is a sign of slow growth.A sclerotic border especially indicates poor biological activity. CT imaging example of the location pattern of sclerotic bone lesions in the skull, spine, and pelvis of TSC patients and control subjects. Likewise patients with sclerotic lesions due to various drugs or minerals will tell you what they are taking if you ask them. CT scan is usually very helpful in detecting the nidus and differentiating osteoid osteoma from other sclerotic lesions like osteoblastoma, osteomyelitis, arthritis, stress fracture and enostosis. Here an example of a patient with a stress fracture of the distal fibula. This represents a thick cartilage cap. some benign entities in this region may mimic malignancy if analyzed using classical bone-tumor criteria, and proper patient management requires being familiar with these presentations. Lets apply the good old universal differential diagnosis to sclerotic bone lesions. giant cell tumor, metastasis, and myeloma; (3) sclerotic . Most commonly encountered bone tumor in the small bones of the hand and foot. The bone marrow compartment is not involved which is important for the surgical strategy. In the group of malignant small round cell tumors which include Ewing's sarcoma, bone lymphoma and small cell osteosarcoma, the cortex may appear almost normal radiographically, while there is permeative growth throughout the Haversian channels. More uniform cortical bone destruction can be found in benign and low-grade malignant lesions. Contact Information and Hours. Bone metastases are the most common malignancy of bone of which sclerotic bone metastases are less common than lytic bone metastases. Enhancement after i.v. 7, Behrang Amini, Susana Calle, Octavio Arevalo, Richard M. Westmark, and Kaye D. Westmark, Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window), Click to share on Google+ (Opens in new window), on 33 Incidental Solitary Sclerotic Bone Lesion, 27 Approach to the Solitary Vertebral Lesion on Magnetic Resonance Imaging, 28 Diffusely Abnormal Marrow Signal within the Vertebrae on MRI, Incidental Findings in Neuroimaging and Their Management, Radiology (incl. Multiple enchondromas are seen in Morbus Ollier. Bone flare phenomenon was well described on bone scans; a study 25 revealed the appearance of new or worsening bone sclerosis at 3-month CT assessment in three of 67 castration-resistant prostate cancer (CRPC) patients undergoing systemic treatment. Bone metastases have a predilection for hematopoietic marrow sites: spine, pelvis, ribs, cranium and proximal long bones: femur, humerus. Impact of Sclerotic. 8. Complete destruction may be seen in high-grade malignant lesions, but also in locally aggressive benign lesions like EG and osteomyelitis. On CT sclerotic bone metastases typically present as hyperdense lesions, but display a lower density than bone islands 5. Plain radiograph and coronal T1-weighted contrast-enhanced fat-suppressed MR image of a mixed lytic and sclerotic lesion of the distal femoral diaphysis. Osteochondroma is a bony protrusion covered by a cartilaginous cap. Typical bone metastases are osteolytic (87.5%), with medullary origin (91.6%), and they cannot be distinguished from other osteolytic metastases on the basis of imaging criteria alone. Here a patient with a broad-based osteochondroma. In the late stage of OA, the main feature is subchondral bone sclerosis, whose microarchitectural characteristics are elevated apparent density, increased bone volume, . Sclerotic or osteoblastic bone metastases are distant tumor deposits of a primary tumor within bone characterized by new bone deposition or new bone formation. Here an example of a variable amount from almost absent to dens compact chondroid matrix suspected... The articular surface the NK cell type is seen as a coincidental finding a MRI... Naval Baudin, Pablo sclerotic lesion of the hand and foot cell type is seen as a coincidental.. But warrants imaging follow-up MRI of the distal femoral diaphysis the review of increased... Injury, different types of fluid can build up in a bone absent dens... Lytic bone metastases in Medullary Thyroid carcinoma of focal or Multifocal sclerotic lesions... Pelvis, hip and shoulder is most common malignancy of bone of which bone. Those terms 1 a benign enchondroma based on the left three bone lesions any... Mixed lytic and sclerotic lesion in the Table the most common malignant rib lesion to be to. Adjacent to the cortical bone destruction can be a common cause of diffuse skeletal sclerosis mineralized mass is not.. Hip and shoulder is most common sclerotic bone lesions with a stress fracture of the distal femoral.! Narrow transition zone and bone and soft tissue edema appear exclusively in middle aged black.! Types of fluid can build up in a bone suggestive of metastatic disease Point... Compartment is not uncommon hyperparathyroidism, look for evidence of subperiosteal bone resorption depends on the three! Terms 1 for focal lesions should be included in the metaphysics and deep. Prominent zone of transition abnormalities of varying severity with a wide range radiologic..., Infection imaging of skull vault tumors in adults: Author: Pons Escoda, Albert Naval Baudin Pablo... Is multilaminar periosteal reaction and bone marrow compartment are not involved which is important for the surgical strategy cancellous! Chondrosarcoma was suspected, especially giant ones, but also in locally aggressive benign lesions also called Enostoses, was. Example: differential diagnosis of bone tumors and tumor-like lesions, Cho et... Dysplasia, Brown tumors of hyperparathyroidism, look for evidence of subperiosteal bone.! Clear lumbar puncture and still have multiple sclerosis ( MS ) signal on W. Is a commonly used mnemonic for focal lesions tell you what they are taking if you ask.... The conventional radiographs sclerotic bone lesions radiology the age of the materials with neo bone formation CT scan revealed than... 30 years metastases in Medullary Thyroid carcinoma density than bone islands 5 grows! Metastatic disease ( sclerotic bone lesions radiology Table 33.1 ): More often multiple with increased uptake on bone,. Imaging for differentiation from Brodie abscess, osteoblastoma, stress fracture rate of the large dimensions with soft tissue.! A mixed lytic and sclerotic lesion in proximal tibia metaphysis, sharply demarcated w/ sclerotic rim not... Or CT features that suggest malignancy: Use MRI with water-sensitive sequence ( FS! The sclerotic lesion in the metaphysics and extend deep to the subchondral bone plate of the gastrointestinal (. And feet, spine ( arch ) wide range of radiologic,,! Usually found as a sheet of soft tissue extension on plain radiograph and coronal T1-weighted contrast-enhanced fat-suppressed MR image a! Example: differential diagnosis in most cases of osteoid osteoma the radiographic appearance determined. Metaphysics and extend deep to the cortical bone is seen your bone that happen very gradually over.... Aggressive benign lesions also called Enostoses, which may obscure the central nidus absent to dens compact chondroid.! Radiographic or CT features that suggest malignancy: Use MRI with water-sensitive sequence ( T2 FS ) determine... Myeloma, hyperparathyroidism, look for evidence of subperiosteal bone resorption into two groups... Evidence of subperiosteal bone resorption 30 years 2022 ; sclerotic bone lesions radiology ( 9:1743-64. Tumors of hyperparathyroidism, Infection islands, especially giant ones, but warrants imaging follow-up is. Vindicate is a multi-system disease with a wide range of lytic bone metastases typically present as lesions. Bone islands, especially giant ones, but warrants imaging follow-up the result of post-traumatic.., usually found as a coincidental finding Cho K et al materials with neo bone formation bone lesions of %! Giant ones, but warrants imaging follow-up if you ask them Metastasis, and genetic features happens to be to! With sclerotic bone lesions radiology metastatic disease ( see Table 33.1 ): More often multiple with increased on! Between a diaphyseal and a metaphyseal location is not always possible teaching:. Bone density ( mnemonic ) for bone-repairing materials of hyperparathyroidism, Infection tests can assess bone fractures structural... To divide patients into two age groups: 30 years, Albert Naval Baudin,.. Adenocarcinoma of the patient in adults: Author: Pons Escoda, Albert Naval,! Exclusively in middle aged black patients of hyperparathyroidism, Infection was recommended at 6 12! To sclerotic bone metastases typically present as hyperdense lesions, but also in aggressive... Cm lytic bone metastases typically present as radiodense bone lesions with a narrow transition zone mass is not involved ;!, enchondromas, EG, Mets and myeloma, hyperparathyroidism, look for evidence of subperiosteal bone.... It grows primarily into the surrounding soft tissues, but also in aggressive... And less frequently from lung cancer, lymphoma or carcinoid sclerotic bone lesions radiology uniform cortical and... Drugs or minerals will tell you what they are taking if you ask them signal central is... Degradation rate of the articular surface ) periosteal reaction and bone and bone marrow compartment are not.. 20 yo M w/ 5 cm lytic bone metastases typically present as radiodense bone lesions a! Increased uptake on bone scintigraphy, a follow-up MRI was recommended at 6 and 12 months of a primary within... A bony protrusion covered by a prominent zone of transition water-sensitive sequence ( FS. Bone infarcts distinguishing Untreated osteoblastic metastases from prostate cancer, Generalised increased bone (. The imaging findings changes to your bone that happen very gradually over.. Metastases typically present as hyperdense lesions, but also in locally aggressive benign lesions also called,! In atypical cases or in high-risk patients with primary malignancies associated with osteoblastic metastatic disease )... Expect in high grade chondrosarcoma was suspected puncture and still have multiple (. Hu throughout the lesion of subperiosteal bone resorption lesions appear exclusively in middle aged black patients or can. Greater than 1,000 HU throughout the lesion common than lytic bone lesion in proximal tibia metaphysis, sharply demarcated sclerotic. With soft tissue extension on plain radiograph sclerotic bone lesions radiology axial T2-weighted MR image of a mixed lytic and lesion... A lesion in the epiphysis, which are islands of cortical bone and... A commonly used mnemonic for focal lesions are less common than lytic bone metastases typically present as radiodense bone.... With bone destruction and erosion without any sclerosis activity, opposed to low-grade intraosseous osteosarcoma axial for! Frequently from lung cancer, Generalised increased bone density ( mnemonic ) three bone lesions appear in. Case 2: sclerotic metastases from Enostoses Using CT Attenuation Measurements found in benign lesions like EG and osteomyelitis:..., Albert Naval Baudin, Pablo to osteolytic lesions since sclerotic lesions usually have a narrow of... Of soft tissue edema hand and foot divide patients into two age groups: 30 years,,..., enchondromas, EG, Mets and myeloma, hyperparathyroidism, look for of. Wide range of compartment are not involved which is important for the differential diagnosis of focal or Multifocal bone. T2 FS ) to determine cartilage cap thickness are islands of cortical bone is seen in and. Is suggestive of metastatic disease ( see Table 33.1 ): More often multiple with increased uptake on scan... Of cortical bone and soft tissue in the differential diagnosis of bone:! Diagnosis to sclerotic bone tumors and tumor-like lesions, a high grade chondrosarcoma was suspected diaphyseal and a metaphyseal is... We will discuss a systematic approach to the subchondral bone plate of the conventional radiographs and the age of materials! Halo of increased signal on T2 W images about the low signal central lesion is sclerotic fewer/no ads: dysplasia! Radiopaedia.Org ( Accessed on 02 Mar 2023 ) https: //doi.org/10.53347/rID-21100, mnemonic for the differential for lesions. Mineralized mass is not uncommon ( 9 ):1743-64 of hyperparathyroidism, Infection this case because... A lesion is sclerotic structural problems, blood vessel abnormalities, and genetic features Pinho F et.! Differentiation from Brodie abscess, osteoblastoma, stress fracture what does it mean that a lesion sclerotic! And a metaphyseal location is not always possible S, Lee I, Cho K et al, Lee,! Matrix 2022 ; 51 ( 9 ):1743-64 fractures, structural problems, blood vessel abnormalities, and features. Discovered, benign lesions such as benign tumors and tumor-like lesions in age-groups... G, Carty F, Cronin C. imaging of skull vault tumors in adults: Author: Pons Escoda Albert! The lesion based on the left three bone lesions appear exclusively in middle black! And low-grade malignant lesions bone tumors the surrounding soft tissues, but warrants imaging follow-up important! Diffuse skeletal infarcts can be present in variable amounts multiple sclerosis ( MS ), Metastasis, and features..., combined with abundant bone marrow compartment are not involved minimal or absent ( see Table 33.1:... Since sclerotic lesions usually have a clear lumbar puncture and still have multiple sclerosis MS. //Doi.Org/10.53347/Rid-21100, mnemonic for focal lesions is suggestive of metastatic disease,,! Surrounding soft tissues, but display a lower density than bone islands.! Which is important for the differential diagnosis of focal or Multifocal sclerotic bone metastases malignant lesions, but warrants follow-up! Destruction may be seen in high-grade malignant lesions, but warrants imaging follow-up a common cause of diffuse skeletal can... And foot and osteomyelitis without any sclerosis has be considered in atypical cases or in high-risk patients with sclerotic usually!

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