2. • Clues by Appearance of Lesion
• Clues by Location of Lesion
• Clues by Density of Lesion
• Other Clues
3. Clues by Appearance of
Lesion
• Patterns of Bone Destruction
• Periosteal Reactions
• Tumor Matrix
• Expansile Lesions of Bone
4. Clues by Appearance of
Lesion
• Patterns of Bone Destruction
– Geographic
– Moth-eaten
– Permeative
5. Geographic Bone
Destruction
• Destructive lesion with sharply
defined border
• Implies a less-aggressive, more slow-
growing, benign process
• Narrow transition zone
6. Patterns of Bone Destruction
– Geographic
– Moth-eaten
– Permeative
Non-ossifying fibroma
11. Permeative Bone Destruction
• Ill-defined lesion with multiple
“worm-holes”
• Spreads through marrow space
• Wide transition zone
• Implies an aggressive malignancy
• Round-cell lesions
12. Patterns of Bone Destruction
– Geographic
– Moth-eaten
– Permeative
Leukemia
33. Clues by Location of Lesion
• In the Transverse Plane
• In the Longitudinal Plane
• Characteristic Locations by tumors
• Characteristic Tumors by Body Site
– Pelvic Lesions
– Expansile Rib Lesions
– Lesions of the Spine
42. Clues by Density of
Lesion
• Sclerotic Cortical Lesions
• Lytic Lesions in Children
• Lytic Lesions in Adults
• Blastic Lesions in Children
• Blastic Lesions in Adults
56. Soft Tissue Extension
• Usually implies malignancy
• More likely to form discrete soft tissue
mass
• Benign conditions with soft tissue
extension
• Osteomyelitis
– Usually infiltration of fat
