Department of Radiology, University of Szeged
Imaging of the skeleton
Department of Radiology, University of Szeged
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
Department of Radiology, University of Szeged
Department of Radiology, University of Szeged
Department of Radiology, University of Szeged
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
Department of Radiology, University of Szeged
Department of Radiology, University of Szeged
Department of Radiology, University of Szeged
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
Department of Radiology, University of Szeged
Department of Radiology, University of Szeged
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
Department of Radiology, University of Szeged
Department of Radiology, University of Szeged
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
Department of Radiology, University of Szeged
Department of Radiology, University of Szeged
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
Department of Radiology, University of Szeged
Department of Radiology, University of Szeged
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
Department of Radiology, University of Szeged
Department of Radiology, University of Szeged
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)
Department of Radiology, University of Szeged
Department of Radiology, University of Szeged
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)
Department of Radiology, University of Szeged
Department of Radiology, University of Szeged
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)
Department of Radiology, University of Szeged
Department of Radiology, University of Szeged
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)
Department of Radiology, University of Szeged
Osteoatrophy (Sudeck sy.)
Department of Radiology, University of Szeged
Osteoporosis
Department of Radiology, University of Szeged
Rickets (Vitamin D deficiency – child)
Department of Radiology, University of Szeged
Osteomalacia (Vitamin D deficiency – adult)
Department of Radiology, University of Szeged
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)
Department of Radiology, University of Szeged
Osteonecrosis (child)
Department of Radiology, University of Szeged
Osteonecrosis (adult)
Department of Radiology, University of Szeged
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)
Department of Radiology, University of Szeged
Department of Radiology, University of Szeged
Bone diseases:
• congenital malformations
• metabolic diseases
• sterile necrosis
• infection
• primary bone tumor
• metastasis
• fracture
Department of Radiology, University of Szeged
Department of Radiology, University of Szeged
Bone diseases:
• congenital malformations
• metabolic diseases
• sterile necrosis
• infection
• primary bone tumor
• metastasis
• fracture
Department of Radiology, University of Szeged
Department of Radiology, University of Szeged
Bone diseases:
• congenital malformations
• metabolic diseases
• sterile necrosis
• infection
• primary bone tumor
• metastasis
• fracture
Department of Radiology, University of Szeged
Department of Radiology, University of Szeged
Bone diseases:
• congenital malformations
• metabolic diseases
• sterile necrosis
• infection
• primary bone tumor
• metastasis
• fracture
Department of Radiology, University of Szeged
Department of Radiology, University of Szeged
Department of Radiology, University of Szeged
Department of Radiology, University of Szeged
Bone diseases:
• congenital malformations
• metabolic diseases
• sterile necrosis
• infection
• primary bone tumor
• metastasis
• fracture
Department of Radiology, University of Szeged
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
Department of Radiology, University of Szeged
benign semimalignant malignant osteogenetic osteoblastoma osteosarcoma chondrogenetic chondroblastoma chondrosarcoma myelogenetic Ewing sarcoma, myeloma collagenetic osteoclastoma fibrosarcoma
Classification of primary bone tumors II: neoplasms
Department of Radiology, University of Szeged
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 - +/-
Department of Radiology, University of Szeged
Department of Radiology, University of Szeged
Department of Radiology, University of Szeged
Department of Radiology, University of Szeged
Department of Radiology, University of Szeged
Department of Radiology, University of Szeged
Department of Radiology, University of Szeged
Department of Radiology, University of Szeged
Department of Radiology, University of Szeged
Bone diseases:
• congenital malformations
• metabolic diseases
• sterile necrosis
• infection
• primary bone tumor
• metastasis
• fracture
Department of Radiology, University of Szeged
Detection of bone metastases
bone scintigraphy
+ - x-ray stop
met. other neg.
stop stop MRI
Department of Radiology, University of Szeged
Department of Radiology, University of Szeged
Department of Radiology, University of Szeged
Department of Radiology, University of Szeged
Department of Radiology, University of Szeged
Department of Radiology, University of Szeged
Bone diseases:
• congenital malformations
• metabolic diseases
• sterile necrosis
• infection
• primary bone tumor
• metastasis
• fracture (next semester…)
Department of Radiology, University of Szeged
Department of Radiology, University of Szeged
Department of Radiology, University of Szeged