A. Mark Davies

The diagnostic accuracy of MR imaging in osteoid osteoma

Abstract Objective. To analyse the MR imaging appearances of a large series of osteoid osteomas, to assess the ability of MR imaging to detect the tumour, and to identify potential reasons for misdiagnosis. Design and patients. The MR imaging findings of 43 patients with osteoid osteoma were reviewed retrospectively and then compared with other imaging modalities to assess the accuracy of MR localisation and interpretation. Results. The potential for a missed diagnosis was 35% based solely on the MR investigations. This included six tumours which were not seen and nine which were poorly visualised. The major determinants of the diagnostic accuracy of MR imaging were the MR technique, skeletal location, and preliminary radiographic appearances. There was a wide spectrum of MR signal appearances of the lesion. The tumour was identified in 65% of sequences performed in the axial plane. The nidus was present in only one slice of the optimal sequence in 27 patients. Reactive bone changes were present in 33 and soft tissue changes in 37 patients. Conclusion. Reliance on MR imaging alone may lead to misdiagnosis. As the osteoid osteoma may be difficult to identify and the MR features easily misinterpreted, optimisation of MR technique is crucial in reducing the risk of missing the diagnosis. Unexplained areas of bone marrow oedema in particular require further imaging (scintigraphy and CT) to exclude an osteoid osteoma.

Osteochondroma and secondary synovial osteochondromatosis.

Abstract Secondary synovial osteochondromatosis (SOC) is a rare disorder caused by a variety of joint disorders. Two unusual cases of secondary SOC are presented. The first patient is a 43-year-old man with extensive SOC developing within a bursa surrounding an osteochondroma of the pubic bone. The second patient is a 23-year-old man who developed florid and progressive SOC of his hip joint following excision of a femoral neck osteochondroma. SOC recurred despite three excisions over a 15-month period. Imaging was useful in pre-operative diagnosis of bursal SOC in the first patient and in detecting multiple recurrences in the second patient. Both cases illustrate prominent SOC developing secondary to osteochondroma. The different hypotheses regarding bursal and secondary SOC are reviewed.

Imaging of bone tumors and tumor-like lesions :

Imaging of bone tumors and tumor-like lesions : , Imaging of bone tumors and tumor-like lesions : , کتابخانه دیجیتال جندی شاپور اهواز

Soft Tissue Tumors with Muscle Differentiation

The working group of the World Health Organization (WHO) updated its classification of soft tissue and bone tumors in 2002, and modifications were made primarily to the nomenclature for soft tissue neoplasms. This review presents the imaging features, patient demographics, and clinicopathological findings for benign and malignant skeletal and smooth muscle tumors using the current WHO classification system.

Radiation-Induced Tumours

• Radiation-induced bone tumours include osteochondroma and sarcoma, most commonly osteosarcoma.

Imaging of the hand and wrist

Imaging of the hand and wrist : , Imaging of the hand and wrist : , کتابخانه دیجیتال جندی شاپور اهواز

Tumours and Tumour-Like Lesions of Bone

Bone tumours affecting the hand and wrist are rare. Only 2% of a series of 4,277 bone tumours were located in the hand or wrist. Furthermore, primary bone tumours are uncommon when compared with tumours arising in the soft tissues of the hand. Haber described 2,321 tumours of the hand with only 38 cases involving bone.

Musculoskeletal imaging: current and future trends

Advances in imaging technology and the increasing role of interventional procedures in musculoskeletal imaging have continued to stimulate research over recent years. This review summarises some recent articles on musculoskeletal radiology topics and looks forward to potential future developments in this exciting sub-speciality.

Imaging in skeletal paediatric oncology

The prognosis for the child presenting with a bone sarcoma has improved dramatically with the introduction of adjuvent chemotherapy. As a result the majority of patients can now expect to undergo limb salvage surgery. The role of imaging in the management of the child presenting with a suspected sarcoma is presented. This commences with tumour detection, through diagnosis and surgical staging, re-staging with assessment of response to chemotherapy and follow-up surveillance for the development of local recurrence and/or metastases. The importance of the multidisciplinary approach to the management of bone sarcomas is emphasised.

Congenital and Developmental Disorders

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