Skip to main content
SpringerLink
Log in

Bone Tumors: Radiographic Pitfalls

  • Chapter
  • First Online:
Pitfalls in Musculoskeletal Radiology

Abstract

Focal bone lesions are quite commonly encountered and can be identified incidentally on radiographs or as part of a focused diagnostic evaluation. Many of these bone lesions are not true bone tumors and can be potential pitfall on radiographs. These potential radiographic pitfalls include pseudo-lesions, normal anatomical variants, and other benign osseous lesions such as Brodie abscess, fibrous dysplasia, stress fracture, bone infarct, myositis ossificans, brown tumor, and subchondral cyst. Recognizing these entities and distinguishing them from bone tumors is a critical radiological skill. A radiologist should have a basic understanding of the epidemiology, symptomatology, classic anatomical locations, characteristic imaging appearances, and differential diagnosis of these potential bone tumor pitfalls in order to avoid misdiagnosis and unnecessary interventions.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 179.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Agarwal G, Mishra SK, Kar DK et al (2002) Recovery pattern of patients with osteitis fibrosa cystica in primary hyperparathyroidism after successful parathyroidectomy. Surgery 132:1075–1085

    Article  PubMed  Google Scholar 

  • Agudelo CA, Wise CM (2001) Gout: diagnosis, pathogenesis, and clinical manifestations. Curr Opin Rheumatol 13:234–239

    Article  CAS  PubMed  Google Scholar 

  • Azouz EM (2002) Magnetic resonance imaging of benign bone lesions: cysts and tumors. Top Magn Reson Imaging 13:219–229

    Article  PubMed  Google Scholar 

  • Bansal A (2008) The dripping candle wax sign. Radiology 246:638–640

    Article  PubMed  Google Scholar 

  • Beaman FD, Peterson JJ (2007) MR imaging of cysts, ganglia, and bursae about the knee. Radiol Clin N Am 45:969–982

    Google Scholar 

  • Bluemke DA, Fishman EK, Scott WW Jr (1994) Skeletal complications of radiation therapy. Radiographics 14:111–121

    Article  CAS  PubMed  Google Scholar 

  • Brandser EA, El-Koury GY, Kathol MH (1995) Adolescent hamstring avulsions that simulate tumors. Emerg Radiol 2:273–278

    Article  Google Scholar 

  • Curtis JA, O’Hara AE, Carpenter GG (1977) Spurs of the mandible and supracondylar process of the humerus in Cornelia de Lange syndrome. AJR Am J Roentgenol 129:156–158

    Article  CAS  PubMed  Google Scholar 

  • De Wilde V, De Maeseneer M, Lenchik L et al (2004) Normal osseous variants presenting as cystic or lucent areas on radiography and CT imaging: a pictorial overview. Eur J Radiol 51:77–84

    Article  PubMed  Google Scholar 

  • Fitzpatrick KA, Taljanovic MS, Speer DP et al (2004) Imaging findings of fibrous dysplasia with histopathologic and intraoperative correlation. AJR Am J Roentgenol 182:1389–1398

    Article  PubMed  Google Scholar 

  • Fong EE (1946) Iliac horns (symmetrical bilateral central posterior iliac processes). Radiology 47:517

    Article  CAS  PubMed  Google Scholar 

  • Freud E (1940) The pathological significance of intraarticular pressure. Edinburgh Med J 47:192

    Google Scholar 

  • Girish G, Glazebrook KN, Jacobson JA (2013) Advanced imaging in gout. AJR Am J Roentgenol 201:515–525

    Article  PubMed  Google Scholar 

  • Gould CF, Ly JQ, Lattin GE Jr et al (2007) Bone tumor mimics: avoiding misdiagnosis. Curr Probl Diagn Radiol 36:124–141

    Article  PubMed  Google Scholar 

  • Greenspan A, Azouz EM (1999) Bone dysplasia series: melorheostosis – review and update. Can Assoc Radiol J 50:324–330

    CAS  PubMed  Google Scholar 

  • Gruber G, Giessauf C, Leithner A et al (2008) Bizarre parosteal osteochondromatous proliferation (Nora lesion): a report of 3 cases and a review of the literature. Can J Surg 51:486–489

    PubMed  PubMed Central  Google Scholar 

  • Hammoud S, Weber K, McCarthy EF (2005) Unicameral bone cysts of the pelvis: a study of 16 cases. Iowa Orthop J 25:69–74

    PubMed  PubMed Central  Google Scholar 

  • Hatzenbuehler J, Pulling TJ (2011) Diagnosis and management of osteomyelitis. Am Fam Physician 84:1027–1033

    PubMed  Google Scholar 

  • Jacobson JA, Girish G, Jiang Y, Sabb BJ (2008) Radiographic evaluation of arthritis: degenerative joint disease and variations. Radiology 248:737–747

    Article  PubMed  Google Scholar 

  • Kavanagh EC, Read P, Carty F et al (2011) Three-dimensional magnetic resonance imaging analysis of hip morphology in the assessment of femoral acetabular impingement. Clin Radiol 66:742–747

    Article  CAS  PubMed  Google Scholar 

  • Khot R, Sikarwar JS, Gupta RP, Sharma GL (2005) Osteopoikilosis: a case report. Indian J Radiol Imaging 15:453–454

    Article  Google Scholar 

  • Kim SY, Park JS, Ryu KN et al (2011) Various tumor-mimicking lesions in the musculoskeletal system: causes and diagnostic approach. Korean J Radiol 12:220–231

    Article  PubMed  PubMed Central  Google Scholar 

  • Klapsinou E, Despoina P, Dimitra D (2012) Cytologic findings and potential pitfalls in proliferative myositis and myositis ossificans diagnosed by fine needle aspiration cytology: report of four cases and review of the literature. Diagn Cytopathol 40:239–244

    Article  PubMed  Google Scholar 

  • Krestan CR, Nemec U, Nemec S (2011) Imaging of insufficiency fractures. Semin Musculoskelet Radiol 15:198–207

    Article  PubMed  Google Scholar 

  • Leri A, Joanny JP (1922) Une affection non de’critedes os: hyperostose “en coule’e” surtoute lalongueur d’un membreou “me’lorhe’ostose”. Bull Mem Soc Med Hop Paris 46:1141–1145

    Google Scholar 

  • Levine AH, Pais MJ, Berinson H, Amenta PS (1976) The soleal line: a cause of tibial pseudoperiostitis. Radiology 119:79–81

    Article  CAS  PubMed  Google Scholar 

  • Mankin H (2009) Nail-patella syndrome: hereditary onycho-osteodysplasia. In: Mankin H (ed) Pathophysiology of orthopaedic diseases. American Academy of Orthopaedic Surgeons, Rosemont

    Google Scholar 

  • Mhuircheartaigh JN, Lin YC, Wu JS (2014) Bone tumor mimickers: a pictorial essay. Indian J Radiol Imaging 24:225–236

    Article  PubMed  PubMed Central  Google Scholar 

  • Mirra JM, Brien EW, Tehranzadeh J (1995) Paget’s disease of bone: review with emphasis on radiologic features – part I. Skeletal Radiol 24:163–171

    CAS  PubMed  Google Scholar 

  • Mitchell MJ, Logan PM (1998) Radiation-induced changes in bone. Radiographics 18:1125–1136

    Article  CAS  PubMed  Google Scholar 

  • Murphey MD, Foreman KL, Klassen-Fischer MK et al (2014) From the radiologic pathology archives. Imaging of osteonecrosis: radiologic-pathologic correlation. Radiographics 34:1003–1028

    Article  PubMed  Google Scholar 

  • Mysorekar VR, Nandedkar AN (1983) The soleal line. Anat Rec 206:447–451

    Article  CAS  PubMed  Google Scholar 

  • Nayak SR, Das S, Krishnamurthy A et al (2009) Supratrochlear foramen of the humerus: an anatomico-radiological study with clinical implications. Ups J Med Sci 114:90–94

    Article  PubMed  PubMed Central  Google Scholar 

  • Nokes SR, Vogler JB, Spritzer CE et al (1989) Herniation pits of the femoral neck: appearance at MR imaging. Radiology 172:231–234

    Article  CAS  PubMed  Google Scholar 

  • Paget J (1877) On a form of chronic inflammation of bones (osteitis deformans). Med Chir Trans (Lond) 60:37–64

    Article  CAS  Google Scholar 

  • Paling MR, Herdt JR (1980) Radiation osteitis: a problem of recognition. Radiology 137:339–342

    Article  CAS  PubMed  Google Scholar 

  • Parikh J, Hyare H, Saifuddin A (2002) The imaging features of post-traumatic myositis ossificans, with emphasis on MRI. Clin Radiol 57:1058–1066

    Article  CAS  PubMed  Google Scholar 

  • Pineda C, Espinosa R, Pena A (2009) Radiographic imaging in osteomyelitis: the role of plain radiography, computed tomography, ultrasonography, magnetic resonance imaging, and scintigraphy. Semin Plast Surg 23:80–89

    Article  PubMed  PubMed Central  Google Scholar 

  • Pitt MJ, Graham AR, Shipman JH, Birkby W (1982) Herniation pit of the femoral neck. AJR Am J Roentgenol 138:1115–1121

    Article  CAS  PubMed  Google Scholar 

  • Resnick D, Cone RO 3rd (1984) The nature of humeral pseudocysts. Radiology 150:27–28

    Article  CAS  PubMed  Google Scholar 

  • Resnick D (2002) Paget’s disease. In: Resnick D (ed) Diagnosis of bone and joint disorders, 4th edn. Saunders, Philadelphia

    Google Scholar 

  • Rhaney K, Lamb DW (1955) The cysts of osteoarthritis of the hip: a radiologic and pathologic study. J Bone Joint Surg Br 37:663–875

    Article  PubMed  Google Scholar 

  • Shah ZK, Peh WCG, Koh WL, Shek TWH (2005) Magnetic resonance imaging appearances of fibrous dysplasia. Br J Radiol 78:1104–1115

    Article  CAS  PubMed  Google Scholar 

  • Shikhare SN, Singh DR, Shimpi TR, Peh WCG (2011) Tuberculous osteomyelitis and spondylodiscitis. Semin Musculoskelet Radiol 15:446–458

    Article  PubMed  Google Scholar 

  • Stacy GS, Kapur A (2011) Mimics of bone and soft tissue neoplasms. Radiol Clin N Am 49:1261–1286

    Google Scholar 

  • Sureka B, Mittal MK, Udhaya K et al (2014) Melorheostosis: two atypical cases. Indian J Radiol Imaging 24:192–195

    Article  PubMed  PubMed Central  Google Scholar 

  • Taljanovic MS, Hoover K (2015) Musculoskeletal system. In: Peh WCG (ed) Pitfalls in diagnostic imaging. Springer, Berlin/Heidelberg

    Google Scholar 

  • Tehranzadeh J (1987) The spectrum of avulsion and avulsion-like injuries of the musculoskeletal system. Radiographics 7:945–974

    Article  CAS  PubMed  Google Scholar 

  • Tehranzadeh J, Wong E, Wang F, Sadighpour M (2001) Imaging of osteomyelitis in the mature skeleton. Radiol Clin North Am 39:223–250

    Article  CAS  PubMed  Google Scholar 

  • Theodorou DJ, Theodorou SJ, Kakitsubata Y (2011) Imaging of Paget disease of bone and its musculoskeletal complications: review. AJR Am J Roentgenol 196:S64–S75

    Article  PubMed  Google Scholar 

  • West JA, Louis TH (2015) Radiographic findings in the nail-patella syndrome. Proc (Bayl Univ Med Cent) 28:334–336

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Diagnostic Radiology, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore, 768828, Republic of Singapore

    Sumer N. Shikhare DNB, MMed, FRCR, Niraj Dubey MD, FRCR & Wilfred C. G. Peh MD, FRCPE, FRCPG, FRCR

Authors
  1. Sumer N. Shikhare DNB, MMed, FRCR
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Niraj Dubey MD, FRCR
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Wilfred C. G. Peh MD, FRCPE, FRCPG, FRCR
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sumer N. Shikhare DNB, MMed, FRCR .

Editor information

Editors and Affiliations

  1. Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Singapore, Singapore

    Wilfred C. G. Peh

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this chapter

Cite this chapter

Shikhare, S.N., Dubey, N., Peh, W.C.G. (2017). Bone Tumors: Radiographic Pitfalls. In: Peh, W. (eds) Pitfalls in Musculoskeletal Radiology. Springer, Cham. https://doi.org/10.1007/978-3-319-53496-1_30

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-53496-1_30

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-53494-7

  • Online ISBN: 978-3-319-53496-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation