Ewing's sarcoma x ray

Ewing's sarcoma Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Suveenkrishna Pothuru, M.B,B.S. [2] Assistant Editor(s)-In-Chief: Michael Maddaleni, B.S.

Overview

On x-ray, Ewing sarcoma is characterized by permeative lytic lesion, periosteal reaction, and soft tissue calcification.

X Ray

X ray add valuable information in the initial evaluation of Ewing sarcoma.The appearance of these tumors is variable, but usually have aggressive appearance. Common findings include:

• Permeative lytic lesion in the metaphysis and diaphysis of the bone with a prominent soft tissue mass extending from the bone.
• Periosteal reaction usually is present, and it often has an onionskin or sunburst pattern, which indicates an aggressive process.
• Codman triangle may be present at the margins of the lesion. These result from the elevation of the periosteum and central destruction of the periosteal reaction caused by the tumor.
• The wide zone of transition (e.g. permeative) is the most useful plain film characteristic in differentiation of benign versus aggressive or malignant lytic lesions.
• Soft tissue calcification is uncommon, seen in less than 10% of cases.

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  X-Ray of a child with Ewing's sarcoma of the tibia.
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  Radiograph demonstrates classic sunburst pattern of periosteal reaction.