bone diseases 1 ppt

RADIOLOGY BONE DISEASE

Imaging technique
I.plain bone radiograph :
Radiological X.ray sings of bone disease :
1.decrease in bone density , it can be focal or generalized

2-increase bone density ( sclerosis ) can also be focal or generalized

3-periosteal reaction

4- cortical thickening

5. alteration in trabecular pattern

6- alteration in the shape of bone e.g acromegaly

7- alteration in bone age
II. U/S in musculoskeletal disease
III. radionuclide bone scanning

IV. computed tomography in bone disease (CT scan ) :

1.Demonestrating abnormality in the pelvis and spine
2.Demonstrating the extent & characterization of bone tumour in selected cases to complement MRI
3.As gide of bone biopsy

V.MRI (magnetic resonance imaging in bone disease ):

.demonstrate disc herniation and spinal cord or nerve root compression
. to diagnose bone metastasis
.show extent of primary bone tumor & demonstrate myloma & lymphoma
. image soft tissue mass
. to diagnose osteomylitis & show any soft tissue abnormality
. to diagnose a vascular necrosis & other joint pathology .

Bone diseases

Solitary bone lesion are usually one of the following
.bone tumor: malignant ( primary or secondary ) , benign
. osteomyelitis
. bone cyst, fibrous dysplasia or other non –neoplastic defects of bone
. condition of uncertain nature such as langerhans histiocystosis

the initial radiological decision is usually to try &decide whether the solitary lesion is benign or its aggressive by looking for the following features on plain radiographs & CT :
1.Zone of transition
2.The adjacent cortex

3.Expansion

4.Periosteal reaction

the causes of localized peiosteal reactions adjacent to a lytic or sclerotic lesions are :

.Osteomyelitis
.Malignant bone tumour , particularly Ewing sarcoma & osteosarcoma
.Occasionally metastasis , particularly neuroblastoma
.Langerhans histiocytosis
.Trauma
5. Calcific densities within the lesion

6. Soft tissue swelling

7.Site:The site of a lesion is most important as certain lesions tend to occur at certain sites.

Bone tumours

Primary malignant tumours
Osteosarcoma ( osteogenic sarcoma )

Chondrosarcoma :

Ewing sarcoma

Giant cell tumour

Benign tumour & tumour like condition

Enchondromas :

Fibrous cortical defects ( non ossifying fibromas )

Fibrous dysplasia :

A simple bone cyst :

Aneurysmal bone cysts :

Osteoid osteoma :

Eosinophilic granuloma :