Osteosarcoma x ray: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
 
(5 intermediate revisions by 2 users not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__


{{CMG}}; {{AE}}[[User:DrMars|Mohammadmain Rezazadehsaatlou[2]]].
{{CMG}}; {{AE}}[[User:DrMars|Mohammadmain Rezazadehsaatlou[2]]]
{{Osteosarcoma}}
{{Osteosarcoma}}
==Overview==
==Overview==
On x-ray, osteosarcoma is characterized by [[medullary]] and [[cortical bone]] destruction, [[periosteal reaction]], tumor matrix [[calcification]], and soft tissue mass.<ref name="radio2">Osteosarcoma. Dr Amir Rezaee ◉ and Dr Frank Gaillard ◉ et al. Radiopaedia.org 2015. http://radiopaedia.org/articles/osteosarcoma</ref>
On [[X-ray]], [[osteosarcoma]] is characterized by [[medullary]] and [[cortical bone]] destruction, [[periosteal reaction]], tumor matrix [[calcification]], and soft tissue mass.
 
==X Ray==
Conventional radiography continues to play an important role in diagnosis of osteosarcoma. Typical appearances of conventional high grade [[osteosarcoma]] include:<ref name="radio2">Osteosarcoma. Dr Amir Rezaee ◉ and Dr Frank Gaillard ◉ et al. Radiopaedia.org 2015. http://radiopaedia.org/articles/osteosarcoma</ref><ref name="pmid6425164">{{cite journal |vauthors=Gürtler KF, Riebel T, Beron G, Heller M, Euler A |title=[Comparison of x-ray plain films, x-ray tomograms and computed tomograms in lung nodules in children and adolescents] |language=German |journal=Rofo |volume=140 |issue=4 |pages=416–20 |date=April 1984 |pmid=6425164 |doi=10.1055/s-2008-1052998 |url=}}</ref><ref name="pmid3022331">{{cite journal |vauthors=Riebel T, Knop J, Winkler K, Delling G |title=[Comparative x-ray and nuclear medical studies of osteosarcomas to evaluate the effectiveness of preoperative chemotherapy] |language=German |journal=Rofo |volume=145 |issue=4 |pages=365–72 |date=October 1986 |pmid=3022331 |doi=10.1055/s-2008-1048952 |url=}}</ref><ref name="pmid3889998">{{cite journal |vauthors=Dinkel E, Uhl H, Roeren T |title=[Lung metastases--limitations and possibilities of radiologic diagnosis] |language=German |journal=Radiologe |volume=25 |issue=4 |pages=158–65 |date=April 1985 |pmid=3889998 |doi= |url=}}</ref><ref name="pmid7042255">{{cite journal |vauthors=Kesselring FO, Penn W |title=Radiological aspects of 'classic' primary osteosarcoma: value of some radiological investigations: A review |journal=Diagn Imaging |volume=51 |issue=2 |pages=78–92 |date=1982 |pmid=7042255 |doi= |url=}}</ref><ref name="pmid27229874">{{cite journal |vauthors=Kubo T, Furuta T, Johan MP, Adachi N, Ochi M |title=Percent slope analysis of dynamic magnetic resonance imaging for assessment of chemotherapy response of osteosarcoma or Ewing sarcoma: systematic review and meta-analysis |journal=Skeletal Radiol. |volume=45 |issue=9 |pages=1235–42 |date=September 2016 |pmid=27229874 |doi=10.1007/s00256-016-2410-y |url=}}</ref><ref name="pmid27154292">{{cite journal |vauthors=Rothermundt C, Seddon BM, Dileo P, Strauss SJ, Coleman J, Briggs TW, Haile SR, Whelan JS |title=Follow-up practices for high-grade extremity Osteosarcoma |journal=BMC Cancer |volume=16 |issue= |pages=301 |date=May 2016 |pmid=27154292 |pmc=4859955 |doi=10.1186/s12885-016-2333-y |url=}}</ref>


==X Ray<ref name="pmid6425164">{{cite journal |vauthors=Gürtler KF, Riebel T, Beron G, Heller M, Euler A |title=[Comparison of x-ray plain films, x-ray tomograms and computed tomograms in lung nodules in children and adolescents] |language=German |journal=Rofo |volume=140 |issue=4 |pages=416–20 |date=April 1984 |pmid=6425164 |doi=10.1055/s-2008-1052998 |url=}}</ref><ref name="pmid3022331">{{cite journal |vauthors=Riebel T, Knop J, Winkler K, Delling G |title=[Comparative x-ray and nuclear medical studies of osteosarcomas to evaluate the effectiveness of preoperative chemotherapy] |language=German |journal=Rofo |volume=145 |issue=4 |pages=365–72 |date=October 1986 |pmid=3022331 |doi=10.1055/s-2008-1048952 |url=}}</ref><ref name="pmid3889998">{{cite journal |vauthors=Dinkel E, Uhl H, Roeren T |title=[Lung metastases--limitations and possibilities of radiologic diagnosis] |language=German |journal=Radiologe |volume=25 |issue=4 |pages=158–65 |date=April 1985 |pmid=3889998 |doi= |url=}}</ref><ref name="pmid7042255">{{cite journal |vauthors=Kesselring FO, Penn W |title=Radiological aspects of 'classic' primary osteosarcoma: value of some radiological investigations: A review |journal=Diagn Imaging |volume=51 |issue=2 |pages=78–92 |date=1982 |pmid=7042255 |doi= |url=}}</ref><ref name="pmid27229874">{{cite journal |vauthors=Kubo T, Furuta T, Johan MP, Adachi N, Ochi M |title=Percent slope analysis of dynamic magnetic resonance imaging for assessment of chemotherapy response of osteosarcoma or Ewing sarcoma: systematic review and meta-analysis |journal=Skeletal Radiol. |volume=45 |issue=9 |pages=1235–42 |date=September 2016 |pmid=27229874 |doi=10.1007/s00256-016-2410-y |url=}}</ref><ref name="pmid27154292">{{cite journal |vauthors=Rothermundt C, Seddon BM, Dileo P, Strauss SJ, Coleman J, Briggs TW, Haile SR, Whelan JS |title=Follow-up practices for high-grade extremity Osteosarcoma |journal=BMC Cancer |volume=16 |issue= |pages=301 |date=May 2016 |pmid=27154292 |pmc=4859955 |doi=10.1186/s12885-016-2333-y |url=}}</ref>==
Conventional radiography continues to play an important role in diagnosis of osteosarcoma. Typical appearances of conventional high grade osteosarcoma include:<ref name="radio2">Osteosarcoma. Dr Amir Rezaee ◉ and Dr Frank Gaillard ◉ et al. Radiopaedia.org 2015. http://radiopaedia.org/articles/osteosarcoma</ref>
*[[Medullary]] and [[cortical bone]] destruction.
*[[Medullary]] and [[cortical bone]] destruction.
*Wide zone of transition, permeative or moth-eaten appearance.
*Wide zone of [[transition]], permeative or moth-eaten appearance.
*Aggressive [[periosteal reaction]] characterized by:
*Aggressive [[periosteal reaction]] characterized by:
:*Sunburst appearance
:*Sunburst appearance
Line 63: Line 64:
*Typically seen as an expansile lytic metaphyseal bony lesion.
*Typically seen as an expansile lytic metaphyseal bony lesion.
*Geographic bony destruction with wide zone of transition tends to be more common than permeative bony destruction.
*Geographic bony destruction with wide zone of transition tends to be more common than permeative bony destruction.
*Less osteoid matrix compared from conventional type.
*Less osteoid matrix compared to conventional type.
|-
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
:Low grade osteosarcoma
:Low grade osteosarcoma
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
*Because the [[fibrous dysplasia]] and central low-grade osteosarcoma are so similar histologically, the radiographic features are an extremely important part of the diagnosis.
*Because the [[fibrous dysplasia]] and central low-grade [[osteosarcoma]] are so similar histologically, the radiographic features are an extremely important part of the diagnosis.
*Radiographic features of low grade osteosarcomas are variable.
*Radiographic features of low-grade osteosarcomas are variable.
*Most common pattern is as a large intracompartmental expansile lytic fibro-osseous lesion with coarsely thick or thin incomplete trabeculations. Another less common pattern is as a dense sclerotic lesion.
*Most common pattern is as a large intracompartmental expansile lytic fibro-osseous lesion with coarsely thick or thin incomplete trabeculations. Another less common pattern is as a sclerotic lesion.
*Cortical erosion and soft tissue extension is also a common feature.
*Cortical [[Erosion (dental)|erosion]] and soft tissue extension is also a common feature.
|-
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
:Extra skeletal osteosarcoma
:Extra skeletal osteosarcoma
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
*Soft tissue density with variable amount of calcification which represents osteoid matrix formation, and is seen in approximately 50% of cases.
*Soft tissue density with a variable amount of calcification which represents osteoid matrix formation, and is seen in approximately 50% of cases.
|-
|-
|}
|}

Latest revision as of 13:26, 17 October 2019


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohammadmain Rezazadehsaatlou[2]

Osteosarcoma Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Osteosarcoma from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Staging

History and Symptoms

Physical Examination

Laboratory Findings

Biopsy

X Ray

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Osteosarcoma x ray On the Web

Most recent articles

cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Osteosarcoma x ray

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Osteosarcoma x ray

CDC on Osteosarcoma x ray

Osteosarcoma x ray in the news

Blogs on Osteosarcoma x ray

Directions to Hospitals Treating Osteosarcoma

Risk calculators and risk factors for Osteosarcoma x ray

Overview

On X-ray, osteosarcoma is characterized by medullary and cortical bone destruction, periosteal reaction, tumor matrix calcification, and soft tissue mass.

X Ray

Conventional radiography continues to play an important role in diagnosis of osteosarcoma. Typical appearances of conventional high grade osteosarcoma include:[1][2][3][4][5][6][7]

  • Sunburst appearance
  • Codman triangle
  • Lamellated (onion skin) reaction: less frequently seen
  • Variable: reflects a combination of the amount of tumor bone production, calcified matrix, and osteoid.
  • Ill-defined fluffy or cloud-like cf. to the rings and arcs of chondroid lesions.
  • The following table illustrates the findings on x-ray for the subtypes of osteosarcoma:[1]
Subtype X-Ray findings
Intracortical osteosarcoma
  • Presents as an oval intracortical geographic osteolytic lesion in the diaphysis with surrounding sclerosis.
  • Measures approximately 4 cm in length.
  • Multiple calcific foci can be seen within the lytic region, suggesting osteoid matrix.
Parosteal osteosarcoma
  • Large lobulated exophytic, 'cauliflower-like' mass with central dense ossification adjacent to the bone.
  • String sign: Thin radiolucent line separating the tumor from cortex, observed in 30% of cases.
  • Tumor stalk: Grows within tumor in late stages and obliterates the radiolucent cleavage plane.
  • +/- soft tissue mass.
  • Cortical thickening without aggressive periosteal reaction is often seen.
  • Tumor extension into medullary cavity is frequently observed.
Periosteal osteosarcoma
  • Typically seen as a broad-based surface soft-tissue mass causing extrinsic erosion of thickened underlying diaphyseal cortex and perpendicular periosteal reaction extending into the soft-tissue component.
Telangiectatic osteosarcoma
  • Typically seen as an expansile lytic metaphyseal bony lesion.
  • Geographic bony destruction with wide zone of transition tends to be more common than permeative bony destruction.
  • Less osteoid matrix compared to conventional type.
Low grade osteosarcoma
  • Because the fibrous dysplasia and central low-grade osteosarcoma are so similar histologically, the radiographic features are an extremely important part of the diagnosis.
  • Radiographic features of low-grade osteosarcomas are variable.
  • Most common pattern is as a large intracompartmental expansile lytic fibro-osseous lesion with coarsely thick or thin incomplete trabeculations. Another less common pattern is as a sclerotic lesion.
  • Cortical erosion and soft tissue extension is also a common feature.
Extra skeletal osteosarcoma
  • Soft tissue density with a variable amount of calcification which represents osteoid matrix formation, and is seen in approximately 50% of cases.

References

  1. ↑ 1.0 1.1 Osteosarcoma. Dr Amir Rezaee ◉ and Dr Frank Gaillard ◉ et al. Radiopaedia.org 2015. http://radiopaedia.org/articles/osteosarcoma
  2. ↑ Gürtler KF, Riebel T, Beron G, Heller M, Euler A (April 1984). "[Comparison of x-ray plain films, x-ray tomograms and computed tomograms in lung nodules in children and adolescents]". Rofo (in German). 140 (4): 416–20. doi:10.1055/s-2008-1052998. PMID 6425164.
  3. ↑ Riebel T, Knop J, Winkler K, Delling G (October 1986). "[Comparative x-ray and nuclear medical studies of osteosarcomas to evaluate the effectiveness of preoperative chemotherapy]". Rofo (in German). 145 (4): 365–72. doi:10.1055/s-2008-1048952. PMID 3022331.
  4. ↑ Dinkel E, Uhl H, Roeren T (April 1985). "[Lung metastases--limitations and possibilities of radiologic diagnosis]". Radiologe (in German). 25 (4): 158–65. PMID 3889998.
  5. ↑ Kesselring FO, Penn W (1982). "Radiological aspects of 'classic' primary osteosarcoma: value of some radiological investigations: A review". Diagn Imaging. 51 (2): 78–92. PMID 7042255.
  6. ↑ Kubo T, Furuta T, Johan MP, Adachi N, Ochi M (September 2016). "Percent slope analysis of dynamic magnetic resonance imaging for assessment of chemotherapy response of osteosarcoma or Ewing sarcoma: systematic review and meta-analysis". Skeletal Radiol. 45 (9): 1235–42. doi:10.1007/s00256-016-2410-y. PMID 27229874.
  7. ↑ Rothermundt C, Seddon BM, Dileo P, Strauss SJ, Coleman J, Briggs TW, Haile SR, Whelan JS (May 2016). "Follow-up practices for high-grade extremity Osteosarcoma". BMC Cancer. 16: 301. doi:10.1186/s12885-016-2333-y. PMC 4859955. PMID 27154292.

Template:WH Template:WS

Retrieved from "https://www.wikidoc.org/index.php?title=Osteosarcoma_x_ray&oldid=1584812"