A radiograph of bone tumor assessment is essential in diagnosing the bone tumor, helps in classification, and outlines the treatment plan.
How to read the radiograph of a bone tumor??
What is the age of the patient?
Which bone is being involved?
What is the segment of the bone?
Epiphysis
Metaphysis
Diaphysis
Tumor Location in the bone?
Eccentric/ Centric
Cortical/ Juxtacortical
No of lesion?
Solitary/Multiple
What is the lesion doing to the bone?
Sclerotic
Healing Nonossifying fibroma
Osteoma
Metastasis
Ewing sarcoma
Lymphoma
Infract/ Infection
Fibrous dysplasia
Enchondroma
- HOME-LIFE
Osteolytic
Ludwick’s classification
Geographical
1A= Thin Sclerotic Margin
1B= Distinct, well-marginated border but not sclerotic
1C=Indistinct border
Moth-eaten
Permeative
What is bone doing to the tumor in response?
Periosteal reaction
Solid: Single thick layer of periosteum
Lamellated: Multilayered
Spiculated/ Needle-like: Perpendicular, hair on end appearances
Codman’s triangle
What is the zone of transition?
The area between the bone and tumor
Most reliable indicator to differentiate between benign and malignant tumor
Narrow: So well defined can be drawn by pen
Wide: not defined properly
What is the matrix of the tumor?
Chondroid Matrix
- Ring and Arcs
- Pop-corn
- Focal Stippled
- Flocculent
Osteoid Matrix
- Trabecular ossification
- Cloud-like ill-defined ossification
Fibrous Matrix
Example
This is a plane X-ray taken in lateral view of a skeletally immature/mature male/female patient showing a single eccentric osteoclastic lesion in the anterior diaphyseal region with a well-defined border and sclerotic margin ground glass matrix associated with soft tissue swelling suggestive of fibrous dysplasia.
See also: X-RAY READING (TRAUMA)
