4 Solitary or Multiple Osteosclerotic Bone Lesions

CLINICAL IMAGAGINGAN ATLAS OF DIFFERENTIAL DAIGNOSIS

EISENBERG

DR. Muhammad Bin Zulfiqar PGR-FCPS III SIMS/SHL

• Fig B 4-1 Osteoid osteoma. (A) Full and (B) coned views of the midshaft of the femur demonstrate a dense sclerotic zone of cortical thickening laterally, which contains a small oval lucent nidus (arrowhead).

• Fig B 4-2 Osteoblastic metastases. Multiple areas of increased density involving the pelvis and proximal femurs representing metastases from carcinoma of the urinary bladder.

• Fig B 4-3 Ivory vertebrae. (A) Carcinoma of the prostate. (B) Lymphoma.

Fig B 4-4 Osteochondroma of the distal femur. The long axis of the tumor is parallel to that of the femur and pointed away from the knee joint.

• Fig B 4-5 Osteochondroma. Extensive cartilaginous calcification about the proximal fibular lesion.

• Fig B 4-6 Multiple exostoses with sarcomatous degeneration. A chondrosarcoma from one of the many exostoses in this patient appears as a large soft-tissue mass with amorphous calcification.

• Fig B 4-7 Bone infarct. Densely calcified area in the medullary cavity of the humerus with dense streaks extending from the central region.

• Fig B 4-8 Avascular necrosis. Sclerotic changes in the femoral heads bilaterally.

• Fig B 4-9 Chronic osteomyelitis. Ill-defined area of lucency in the distal radial shaft is almost obscured by the sclerotic periosteal new bone formation.

• Fig B 4-10 Brodie's abscess. Well-circumscribed lucent lesion completely fills the femoral medullary canal and is surrounded by dense endosteal sclerosis and cortical thickening (arrow).7

• Fig B 4-11 Garré's sclerosing osteomyelitis. Exuberant sclerotic reaction in the midshaft of the tibia without evidence of bone destruction.

• Fig B 4-12 Paget's disease. (A) Cotton-wool skull. Lateral radiograph shows diffuse calvarial thickening with several areas of focal sclerosis (arrowheads). (B) Ivory vertebra. Frontal radiograph shows diffuse sclerosis in the T10 vertebral body.2

Fig B 4-13 Mastocytosis. Multiple scattered, well-defined sclerotic foci in the pelvis simulate blastic metastases.

• Fig B 4-14 Ewing's sarcoma. Sunburst pattern of horizontal spicules of dense bone.

Fig B 4-15 Chondrosarcoma. Ill-defined, calcium-containing mass near the angle of the scapula.

Fig B 4-16 Osteopoikilosis. Innumerable small, well-circumscribed areas of increased density throughout the pelvis and proximal femurs.

Fig B 4-17 Osteopathia striata. Dense longitudinal striations in the distal femur and proximal tibia.

• Fig B 4-18 Congenital stippled epiphyses. Multiple small punctate calcifications of various sizes involve virtually all the epiphyses in views of (A) the chest and upper abdomen and (B) the lower extremities.

Fig B 4-19 Yaws. Expanding inflammatory process with surrounding sclerosis involving the right forearm.8