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==Overview==
==Overview==




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===Plain Radiograph===
===Plain Radiograph===
'''Periosteal reaction'''
*Also known as " ''periostitis/periosteitis''", is a non specific radiographic finding that occurs with periosteal irritation.
*Periosteal reactions may be broadly characterized by pattern and tumor nature (benign/malignant)
*Periosteal reaction is a radiographic feature that helps to characterize a bone lesion
*Common periosteal reactions, include:
:*Single layer
:*Multilayered (onion-skin)
:*Solid
:*Spiculated
:*Perpendicular (hair-on-end)
:*Divergent (sunburst)
:*Sloping (velvet)
:*Disorganised/complex
:*Codman triangle
'''Location'''
'''Margin'''
'''Opacity '''
'''Mineralization'''
'''Size '''
'''Cortical involvement'''
'''Soft-tissue component'''


===CT===
===CT===

Revision as of 17:55, 12 February 2016

Bone or Cartilage Mass Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]

Overview

Imaging

Plain Radiograph

Periosteal reaction

  • Also known as " periostitis/periosteitis", is a non specific radiographic finding that occurs with periosteal irritation.
  • Periosteal reactions may be broadly characterized by pattern and tumor nature (benign/malignant)
  • Periosteal reaction is a radiographic feature that helps to characterize a bone lesion
  • Common periosteal reactions, include:
  • Single layer
  • Multilayered (onion-skin)
  • Solid
  • Spiculated
  • Perpendicular (hair-on-end)
  • Divergent (sunburst)
  • Sloping (velvet)
  • Disorganised/complex
  • Codman triangle

Location

Margin

Opacity

Mineralization

Size

Cortical involvement

Soft-tissue component

CT

MRI

Gallery

Plain Radiograph

  • Osteosarcoma with Codman triangles: the tumor is essentially lytic and destructive with irregular, permeative margins, and soft tissue extension. Codman triangles (reactive periosteal new bone formation around the edges) are very prominent Adapted from Creative Commons 3.0

    Osteosarcoma with Codman triangles: the tumor is essentially lytic and destructive with irregular, permeative margins, and soft tissue extension. Codman triangles (reactive periosteal new bone formation around the edges) are very prominent
    Adapted from Creative Commons 3.0

  • Giant cell tumor: located on distal radius Adapted from Radiopedia

    Giant cell tumor: located on distal radius
    Adapted from Radiopedia

  • Pathological fracture: located in the metaphyseal region Adapted from Radiopedia

    Pathological fracture: located in the metaphyseal region
    Adapted from Radiopedia

  • Rind sign: a lesion surrounded by a layer of thick, sclerotic reactive bone (rind) and is suggestive of fibrous dysplasia Adapted from Radiopedia

    Rind sign: a lesion surrounded by a layer of thick, sclerotic reactive bone (rind) and is suggestive of fibrous dysplasia
    Adapted from Radiopedia

  • Sunburst appearance: a type of periosteal reaction giving the appearance of a sunburst secondary to an aggressive periostitis. Present in aggresive tumors, such as: osteosarcoma, Ewing sarcoma, and osteoblastic metastases (e.g. prostate, lung or breast cancer) Adapted from Radiopedia

    Sunburst appearance: a type of periosteal reaction giving the appearance of a sunburst secondary to an aggressive periostitis. Present in aggresive tumors, such as: osteosarcoma, Ewing sarcoma, and osteoblastic metastases (e.g. prostate, lung or breast cancer)
    Adapted from Radiopedia

  • Onion skin sign : Also known as "multilayered periosteal reaction" demonstrates multiple concentric parallel layers of new bone adjacent to the cortex, reminiscent of the layers on an onion. Associated with osteosarcoma,Ewing sarcoma, and acute osteomyelitis (*) Parallel layers of new bone Adapted from Radiopedia

    Onion skin sign : Also known as "multilayered periosteal reaction" demonstrates multiple concentric parallel layers of new bone adjacent to the cortex, reminiscent of the layers on an onion. Associated with osteosarcoma,Ewing sarcoma, and acute osteomyelitis (*) Parallel layers of new bone
    Adapted from Radiopedia

  • Cockade sign: Classic appearance of an intraosseous lipoma of the calcaneus which presents as a well-defined lytic lesion with a central calcification resembling a cockade Adapted from Radiopedia

    Cockade sign: Classic appearance of an intraosseous lipoma of the calcaneus which presents as a well-defined lytic lesion with a central calcification resembling a cockade
    Adapted from Radiopedia

  • Geographic skull sign: radiographic appearance which is seen at eosinophilic granuloma. Destructive lytic bone lesion, edges of which may be bevelled, scalloped or confluent Adapted from Radiopedia

    Geographic skull sign: radiographic appearance which is seen at eosinophilic granuloma. Destructive lytic bone lesion, edges of which may be bevelled, scalloped or confluent
    Adapted from Radiopedia

CT

  • String sign : appearance a radiolucent cleavage plane between portions of the tumor and cortex of the affected bone Adapted from Radiopedia

    String sign : appearance a radiolucent cleavage plane between portions of the tumor and cortex of the affected bone
    Adapted from Radiopedia

  • Osteoblastoma: Internal matrix mineralisation is better appreciated on CT Adapted from Radiopedia

    Osteoblastoma: Internal matrix mineralisation is better appreciated on CT
    Adapted from Radiopedia

MRI

References


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