June 20, 2024

A radiograph of bone tumor assessment is essential in diagnosing the bone tumor, helps in classification, and outlines the treatment plan.

Radiograph of bone tumor
Radio

How to read the radiograph of a bone tumor??

What is the age of the patient?

Which bone is being involved?

Radiograph of Exostosis

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

Fibrous Dysplasia

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)