Imaging of the skeleton - u-szeged.hu€¦ · Department of Radiology, University of Szeged Methods of examination: • plain x-ray (radiography, densitometry) •x-ray with contrast

Department of Radiology, University of Szeged

Imaging of the skeleton


Methods of examination:

• plain x-ray (radiography, densitometry) • x-ray with contrast material (fistulography, angiography) • ultrasound (b-mode, Doppler, color, duplex) • computed tomography • magnetic resonance imaging • x-ray-, US-, CT-guided intervention • isotope










• plain x-ray (radiography, densitometry) •x-ray with contrast material (fistulography, angiography) • ultrasound (b-mode, Doppler, color, duplex) • computed tomography • magnetic resonance imaging • x-ray-, US-, CT-guided intervention • isotope


http://www.ajronline.org/content/vol178/issue5/images/large/05_AB1191_03B_NEW.jpeg

http://www.ajronline.org/content/vol188/issue1/images/large/01_05_1067_02A.jpeg













http://jco.ascopubs.org/content/vol22/issue2/images/large/zlj0020408880001.jpeg

http://jco.ascopubs.org/content/vol22/issue2/images/large/zlj0020408880001.jpeg






Primary bone changes:

• change of shape (deformity)

• change of structure (heteroplasia)

• change of calcium content

• increased (osteosclerosis)

• decreased (atrophy, porosis, malacia)

• bone necrosis (osteonecrosis)

• bone destruction (osteolysis)






















http://www.google.hu/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=TE75bG1uluVPqM&tbnid=xHEJrif5-hQRMM:&ved=0CAUQjRw&url=http%3A%2F%2Fwww.sciencedirect.com%2Fscience%2Farticle%2Fpii%2FS0968016006000846&ei=repsUvbxLsPWtAaZ4YCQBA&bvm=bv.55123115,d.Yms&psig=AFQjCNGHlK3E6GSvJbkL5WOFVmB5JnWM6g&ust=1382956071106394

http://www.google.hu/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=eQW96HakfUTODM&tbnid=71fmzNsSdESnzM:&ved=0CAUQjRw&url=http%3A%2F%2Fzl.elsevier.es%2Fes%2Frevista%2Fmedicina-clinica-2%2Fosteopoiquilia-13014325-la-imagen-semana-2001&ei=6OpsUtifEIXVtAag0IDICQ&bvm=bv.55123115,d.Yms&psig=AFQjCNGkw7clz3sAJep3h7bUZTE_62nQ7g&ust=1382956125569097











Osteoatrophy (Sudeck sy.)

http://www.google.hu/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=cM3CuVrzRvWvcM&tbnid=53-0b2fIj2y6tM:&ved=0CAUQjRw&url=http%3A%2F%2Ftrialx.com%2Fcurebyte%2F2012%2F12%2F03%2Fsudecks-atrophy-photos-and-a-listing-of-clinical-trials%2F&ei=MOFsUtCiKsbdtAbpgoCYCg&psig=AFQjCNHbnR6c6WKpPEoZe96NuXF5uYeZnw&ust=1382953644282050


Osteoporosis

http://www.google.hu/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=9Vhf7b-zBOcQ4M&tbnid=EEZUIDtz0husDM:&ved=0CAUQjRw&url=http%3A%2F%2Fhealthtoken.com%2Fosteoporosis-x-ray%2F&ei=neFsUrLUM4aPtAb_toGYCg&psig=AFQjCNHysODt2TBJmiZAozpOzdVgHD2tSg&ust=1382953750065072

http://www.google.hu/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=9Vhf7b-zBOcQ4M&tbnid=EEZUIDtz0husDM:&ved=0CAUQjRw&url=http%3A%2F%2Fcommons.wikimedia.org%2Fwiki%2FFile%3AMedical_X-Ray_imaging_BMJ02_nevit.jpg&ei=CuJsUuo4ioS0BtO5gNAE&psig=AFQjCNHysODt2TBJmiZAozpOzdVgHD2tSg&ust=1382953750065072

http://www.google.hu/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=9Vhf7b-zBOcQ4M&tbnid=EEZUIDtz0husDM:&ved=0CAUQjRw&url=http%3A%2F%2Fwww.ijstd.org%2Farticle.asp%3Fissn%3D0253-7184%3Byear%3D2010%3Bvolume%3D31%3Bissue%3D1%3Bspage%3D30%3Bepage%3D34%3Baulast%3DPatel&ei=M-JsUtT5NIbRtAbpjoFI&psig=AFQjCNHysODt2TBJmiZAozpOzdVgHD2tSg&ust=1382953750065072


Rickets (Vitamin D deficiency – child)


Osteomalacia (Vitamin D deficiency – adult)

http://www.google.hu/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=13eo1xqscfkV9M&tbnid=jEUchzkhSJ_gfM:&ved=0CAUQjRw&url=http%3A%2F%2Fwww.surgical-tutor.org.uk%2Fsystem%2Flocomotor%2Fmetabolic_bone.htm&ei=uc9sUsX7AsiY0QWzzYGACA&bvm=bv.55123115,d.Yms&psig=AFQjCNFcPmcwKWE55DsTIWTzes3b2uwMjw&ust=1382949152371080

http://www.google.hu/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=Ad2-zMrRaiwe7M&tbnid=fVVeWj27-yXkkM:&ved=0CAUQjRw&url=http%3A%2F%2Fwww.learningradiology.com%2Farchives2008%2FCOW%2520321-Shepherds%2520Crook-Pagets%2Fshepherdscorrect.htm&ei=e9BsUq7TAcKw0AWGy4HICA&bvm=bv.55123115,d.Yms&psig=AFQjCNFcPmcwKWE55DsTIWTzes3b2uwMjw&ust=1382949152371080











Osteonecrosis (child)

http://www.google.hu/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=K2V3vN91R3TF2M&tbnid=kvGjlcv_gZ96BM:&ved=0CAUQjRw&url=http%3A%2F%2Fwestjem.com%2Fimages%2Fkohlers-disease.html&ei=zOJsUseXJ8XJswaayIG4AQ&psig=AFQjCNEJw_VHiPpf-WR-9NnhQcm3IeN7nA&ust=1382954040304634

http://www.google.hu/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=YuLJ5EdxilJnJM&tbnid=ANumJr7eXxNGMM:&ved=0CAUQjRw&url=http%3A%2F%2Fwww.wheelessonline.com%2Fortho%2Flegg_calve_perthes_disease&ei=QONsUo_CGIbatAbhr4HgDA&psig=AFQjCNECcFVk7hTdboSsaYd7529Yd02n4Q&ust=1382954147488116


Osteonecrosis (adult)

http://www.google.hu/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=42w6cfZDwFvuBM&tbnid=dbzyNv_7DQN0cM:&ved=0CAUQjRw&url=http%3A%2F%2Fwww.radiologytutorials.com%2Fmain.cgi%3Fframe%3Dmain%26tt%3D1%26s%3D1%26t%3D36%26mod%3Dall&ei=tONsUozFDMjdsgb_7oCQBQ&psig=AFQjCNHS1iE2EYoO-S8bDZYbkJUUu2OtoQ&ust=1382954278851762

http://www.google.hu/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=42w6cfZDwFvuBM&tbnid=dbzyNv_7DQN0cM:&ved=0CAUQjRw&url=http%3A%2F%2Fwww.medscape.org%2Fviewarticle%2F416468_5&ei=2eNsUr63NYfPtAaw2YGoCA&psig=AFQjCNHS1iE2EYoO-S8bDZYbkJUUu2OtoQ&ust=1382954278851762












Bone diseases:

• congenital malformations

• metabolic diseases

• sterile necrosis

• infection

• primary bone tumor

• metastasis

• fracture



Bone diseases:




• infection


• metastasis

• fracture



Bone diseases:




• infection


• metastasis

• fracture


http://www.google.hu/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=Hfm38kiLF3f09M&tbnid=nHtli8H01oDvhM:&ved=0CAUQjRw&url=http%3A%2F%2Frsna2004.rsna.org%2Frsna2004%2FV2004%2Fdps%2Fmedia%2F2%2FHTML%2Favascular_necrosis.htm&ei=ieRsUsnaCJHMswbK0ICQAg&psig=AFQjCNHviYhPCuTluE_jTvjT6QuC1F1SYA&ust=1382954439154781


Bone diseases:




• infection


• metastasis

• fracture


http://www.google.hu/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=uVohgmbhRpm5oM&tbnid=4Y1x7JaJmXmekM:&ved=0CAUQjRw&url=http%3A%2F%2Fwww.learningradiology.com%2Ftoc%2Ftocsubsection%2Ftocarchives2003.htm&ei=-ORsUpfhMMXbtAbVioCIDg&psig=AFQjCNGxZ9VnRbtW8BfJefoBxHuoleTMsw&ust=1382954555142419

http://www.google.hu/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=uVohgmbhRpm5oM&tbnid=4Y1x7JaJmXmekM:&ved=0CAUQjRw&url=http%3A%2F%2Freference.medscape.com%2Ffeatures%2Fslideshow%2Fosteomyelitis&ei=Z-VsUrX8O4jIswac84D4CA&psig=AFQjCNGxZ9VnRbtW8BfJefoBxHuoleTMsw&ust=1382954555142419



http://www.google.hu/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=iNNXwAHUB4jYTM&tbnid=TFlssmIQG6lYUM:&ved=0CAUQjRw&url=http%3A%2F%2Fwww.boneandjoint.org.uk%2Fcontent%2Ffigs-2a-2b-47&ei=wOVsUu-UE8besgaxyYHgAg&psig=AFQjCNFHpUYKf5ZvS-Y54_VZ0qDTptepUA&ust=1382954789110801

http://www.google.hu/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=BW-4t8ZzTS83hM&tbnid=tzBSum4H3mhU5M:&ved=0CAUQjRw&url=http%3A%2F%2Fwww.ruralneuropractice.com%2Farticle.asp%3Fissn%3D0976-3147%3Byear%3D2012%3Bvolume%3D3%3Bissue%3D2%3Bspage%3D221%3Bepage%3D222%3Baulast%3DJoshi&ei=7OVsUpDQEsPVtQbnmYC4CA&psig=AFQjCNG_atnGmFuk4af_dBgsUW5Jbtgk4w&ust=1382954856981168

http://www.google.hu/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=12uij-yTOpGi5M&tbnid=HPvyo4L6XH8x3M:&ved=0CAUQjRw&url=http%3A%2F%2Fradiopaedia.org%2Fimages%2F4581&ei=N-ZsUrK9KMGatQaF_4C4DQ&psig=AFQjCNHB_4BmIB8nTJS6gcqtVjbOSFsGwQ&ust=1382954899350715


Bone diseases:




• infection


• metastasis

• fracture


benign semimalignant reactive hamartoma osteogenetic osteoma osteochondroma osteoid osteoma chondrogenetic enchondroma myelogenetic collagenetic haemangioma fibroma

Classification of primary bone tumors I: reactive lesions and hamartomas


benign semimalignant malignant osteogenetic osteoblastoma osteosarcoma chondrogenetic chondroblastoma chondrosarcoma myelogenetic Ewing sarcoma, myeloma collagenetic osteoclastoma fibrosarcoma

Classification of primary bone tumors II: neoplasms


Indicative signs of bone tumor nature

SIGN Benign Malignant

growth slow fast

contour sharp ill-defined

margin calcification + -

stroma calcification +/- +/-

cortex intact/bulging destroyed

periosteum intact invaded/destroyed

surroundings intact invaded

dissemination - +/-


http://www.google.hu/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=kAEgp_EQxHGExM&tbnid=_UdQXZ-kMLkDBM:&ved=0CAUQjRw&url=http%3A%2F%2Froentgenrayreader.blogspot.com%2F2011%2F07%2Fosteoid-osteoma.html&ei=VedsUoS-Oo3DswbU-YDYDA&psig=AFQjCNELXDqaFAfq_3O9WJkcM-6vJt-lyQ&ust=1382955206283357





http://www.google.hu/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=ytoKWKOtzcuv5M&tbnid=0_e_U3ReEesIEM:&ved=0CAUQjRw&url=http%3A%2F%2Fradiopaedia.org%2Fimages%2F511891&ei=LuhsUuuOD8eKswb5x4GoDw&psig=AFQjCNFjtZq1E9k2l3tOm8PKxJMdufao2Q&ust=1382955423274959



http://www.google.hu/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=LUUUs_zAIgvmPM&tbnid=YPo-AeWn1oFs3M:&ved=0CAUQjRw&url=http%3A%2F%2Fwww.tumorsurgery.org%2Fpatient-education%2Fbone-tumors%2Fbone-tumor-types%2Fewing-sarcoma.aspx&ei=--hsUoqJEcWbtAaA1YEg&bvm=bv.55123115,d.Yms&psig=AFQjCNFOhJla9MWy0A0H_lzoLZqHgk_Fjw&ust=1382955638335944





Bone diseases:




• infection


• metastasis

• fracture


Detection of bone metastases

bone scintigraphy

+ - x-ray stop

met. other neg.

stop stop MRI







Bone diseases:




• infection


• metastasis

• fracture (next semester…)




Documents

Imaging of the skeleton - u-szeged.hu€¦ · Department of Radiology, University of Szeged Methods of examination: • plain x-ray (radiography, densitometry) •x-ray with contrast