1. RADIOLOGY OF BONE TUMOURS

2. BONE TUMOURS CELL OF ORIGIN BENIGN MALIGNANT 1-OSTEOBLAST OSTEOMA
OSTEOSARCOMA
2-CHONDROBLAST
CHONDROMA
CHONDROSARCOMA
CHONDROBLASTOMA
OSTEOCHONDROMA
3-OSTEOCLAST
GIANT CELL TUMOUR
MALIGNANT GIANT CELL TUMOUR
4-U M C (MEDULLA)
ESINOPHILIC GRANULOMA
MYELOMA
ANGIOSARCOMA( EWING’S)
LYMPHOMA (RCS)
5-FIBROBLAST
NON-OSSIFYING FIBROMA
FIBROSARCOMA
6-VARIABLE (extraosseous)
METASTASIS

3. BONE TUMOURS VERTEBRAE FLAT BONES LONG BONES OSTEOID OSTEOMA
METASTASIS
EPIPHYSIS: -GIANT CELL TUMOUR
OSTEOBLASTOMA
MYELOMA
METAPHYSIS: -OSTEOSARCOMA
-CHONDROSARCOMA
CHONDROSARCOMA
DIAPHYSIS: -METASTASIS
-EWING’S SARCOMA

4. BONE TUMOURS METASTASIS ARE THE COMMENEST (1/1000).
MYELOMA IS THE COMMENEST PRIMARY BONE TUMOUR (4/MILLION) THEN OSTEOSARCOMA (2/MILLION).
BONE TUMOURS PRESENTS BY :
PAIN,TENDERNESS,MASS,AND FRACTURE.
BONE TUMOURS METASTASIZE TO LUNG.
NODAL INVOLVEMENT MAY OCCUR IN:
OSTEOSARCOMA,LYMPHOMA,AND EWING’S SARCOMA

5. OSTEOMA ARISE FROM EITHER: -MEMBRANOUS BONE e.g. SKULL (COMPACT,IVORY)
-CARTILAGENOUS BONE (OSTIOID)

6. OSTEOMA (COMPACT)
WELL DEFINED , EXCESSIVLY RADIODENSE LESION WITH NO NEW BONE FORMATION.
X RAY AP VIEW CT AXIAL CUT

7. COMPACT OSTEOMA
CT, TRANSVERSE VIEW D CT

8. OSTEOMA ,OSTEOID
WELL DEFINED RADIOLUCENT LESION SURROUNDED BY SCLEROSIS & CORTICAL THICKENING.
SMALL LESIONS LESS THAN 1 CM= OSTEOID OSTEOMA.
LAGRE LESIONS MORE THAN 1.5 CM = OSTEOBLASTOMA.

9. OSTEOBLASTOMA

10. CHONDROMA YOUNG AGE. SINGLE OR MULTIPLE (OLLIER’S DISEASE). TWO TYPES:
1-CENTRIC (ENCHONDROMA).
2-ECCENTRIC ( ECCHONDROMA).
RADIOLOGICAL APPEARANCE:
-EPIPHYSEO-METAPHYSEAL LESION(AT THE GROWTH PLATE).
-RADIOLUCENT.
-SPECKS OF CALCIFICATION.
(IN CONTRADISTINCTION TO TRUE CYSTS WHICH SHOW NO CALCIFICATION)

11. CHONDROMA
ENCHONDROMA
ECCHONDROMA

12. OLLIER’S DISEASE

13. OSTEOCHONDROMA (EXOSTOSIS)
OUTWARD CARTLAGE OVERGROWTH FROM EPIPHYSEAL PLATE DURING THE PERIOD OF BONE GROWTH( USUALLY BELOW 20 YEARS).
SINGLE OR MULTIPLE.
1% MALIGNANT TRANSFORMATION.
RADIOLOGICAL PICTURE:
1- BONY STALK COVERED BY A CARTILAGENOUS CAP EXTENDING OUTWARDS FROM THE EPIPHYSIO- METAPYSEAL JUNCTION .
3-INCLINED AWAY FROM THE JIONT.

14. OSTEOCHONDROMA

15. OSTEOCHONDROMA

16. OSTEOCHONDROMA

17. OSTEOCHONDROMA ? MALIGNANT TRANSFORMATION (CHONDROSARCOMA)
RAPID GROWTH.
GROWTH AFTER STOPPAGE OF PARENT BONE GROWTH.
RECURRENCE AFTER EXCISION.
INVASION OF PARENT BONE.

18. FIBROMA TEENS. METAPHYSEAL. AROUND THE KNEE. RADIOLUCENT LESION.
SCLEROTIC MARGIN.

19. MALGNANT RADIOLOGIC CRITERIA
ILL DEFINED MARGIN.
BONE DISTRUCTION.
NEO BONE FORMATION.
JOINT INVATION.
SOFT TISSUE INVATION.

20. OSTEOSARCOMA
-SECOND COMMON AFTER MYELOMA (2/MILLION). -RULE OF 80%: - TEENAGERS(ELDER ON TOP OF IRRADIATION OR PAGET’S) - LOWER LIMB. - NEAR THE KNEE. - LOWER FEMUR. - METAPHYSEAL.

21. OSTEOSARCOMA
STARTS AT THE MEDULLA THEN INVADES THE CORTEX & SOFT TISSUE.
IT RARELY INVADES THE EPIPHYSIS.

22. OSTEOSARCOMA - BONE DISTRUCTION - NEO BONE FORMATION:
- METAPHYSEAL LESION .
- BONE DISTRUCTION
- NEO BONE FORMATION:
1- CODMAN’S TRIANGLE (TOWARDS DIAPHYSIS)
2- SUN RAY APPEARANCE

23. OSTEOSARCOMA
PLANE X-RAY MRI

24. PAROSTEAL OSTEOSARCOMA
MASS RELATED TO EXTERNAL ASPECT OF CORTEX PRODUCING: RADIODENSITY SCALOOPING

25. CHONDROSARCOMA THIRD COMMON BONE TUMOUR (1/million). 75% PRIMARY TYPE.
25% SECONDARY ON TOP OF :
-OSTEOCHONDROMA.
-CHONDROMA.
-METAPHYSEAL ACHLASIS.
ELDER.
CHONDRAL BONES : FLAT(PELVIS)
LONG

26. CHONDROSARCOMA RADIOLOGICAL PICTURE: - METAPHYSEAL. - MEDULLARY.
- RADIOLUSANT.
- LITTLE EXPANSION.
- FLECKS OF CALCIFICATION.

27. CHONDROSARCOMA

28. CHONDROSARCOMA, MRI

29. FIBROSARCOMA MIDDLE AGE.
PRIMARY OR ON TOP OF IRRADIATION OR FIBROUS DISPLASIA.

30. FIBROSARCOMA BONE DESTRUCTION. OSTEOLYTIC LESION.
MEDULLARY OR PERIOSTEAL.

31. EWING’S SARCOMA NO BONE IS IMMUNE. YOUNG. ANGIOSARCOMA OF BONE MARROW.
METASTASIS TO LUNGS & NODES.

32. EWING’S SARCOMA DIAPHYSEAL LESION. BONE DESRUCTION.
NEW BONE FORMATION:
ONION SKIN APPEARANCE

33. EWING’S SARCOMA

34. GIANT CELL TUMOUR (OSTEOCLASTOMA)
MIDDLE AGE AFTER EPIPHYSEAL CLOSURE.
DISTAL FEMUR,UPPER TIBIA,UPPER HUMERUS,DISTAL RADIUS.
90% ARE BENIGN.

35. GIANT CELL TUMOUR RADIOLOGICAL PICTURE: -EPIPHYSEAL.
-MULTILOCULAR RADIOLUCENT LESION
(SOAP BUBBLE APPEARANCE).
-MEDULLURY PLUG(OPERCULUM).

36. GIANT CELL TUMOUR

37. GIANT CELL TUMOUR

38. GIANT CELL TUMOUR

39. GIANT CELL TUMOUR LOCALLY INVASIVE LESION Q. MALIGNANT

40. MULTIPLE MYELOMA ARISE FROM PLASMA CELL OF RED BONE MARROW. ELDERLY.
MULTIFOCAL.
ASSOCIATED WITH:
1- AMYLOIDOSIS.
2- MYELOMA KIDNEY(TUBULAR CAST OBSTRUCTION).
3- BONE DESTRUCTIONOSTEOPOROSIS HYPERCALCAEMIA.

41. HYPERCALCAEMIA ANEMEA. NAUSIA. ABDOMINAL PAIN. DEPRESSION. ATHENIA.
POLYUREA.

42. MULTIPLE MYELOMA
CORTICO-MEDULLARY ,MULTIFOCAL,OSTEOLYTIC LESIONS,WITH NO BONE FORMATION (SAME AS METASTASIS)

43. METASTASIS COMMONEST BONE TUMOUR (1/1000). CORTICO-MEDULLARY.
MULTIFOCAL.
USUALLY OSTEOLYTIC EXCEPT(BREAST,PROSTATE).
BEST DIAGNOSIS BY BONE SCAN.
BONE DESTRUCTIONHYPERCALCAEMIA.
COMMON PRIMARIES:
BREAST,PROSTATE,LUNG,KIDNEY,THYROID.

44. METASTASIS
X RAY ,OSTEOLYTIC

45. METASTASIS
X RAY ,OSTEOLYTIC CT, MULTIPLE OSTEOLYTIC

46. METASTASIS
X RAY ,OSTEOLYTIC CT, MULTIPLE OSTEOLYTIC X RAY, OSTEOBLASTIC

47. METASTASIS

48. TC-BONE SCAN
HYPERACTIVE MONOFOCAL LESION

49. TC-BONE SCAN
HYPERACTIVE MULTIFOCAL LESIONS

50. LYMPHOMA MID AGE & ELDER. NON HODIKIN’S (RETICULUM CELL SARCOMA).
AFFECTS RED MARROW IN MEDULLA OF :
- ILIUM.
- SPINE.
- RIBS.
- STERNUM.

51. LYMPHOMA
MOTTLED BONE DESTRUCTION

52. BONE CYSTS
1- SIMPLE. 2- ANEURYSEMAL. 3- FIBROUS DYSPLASIA (PAGET’S). 4- OSTEITIS FIROSA CYSTICA. 5- HYDATID.

53. SIMPLE BONE CYST SINGLE. UNILOCULAR. CLEAR FLUID.
RADIOLOGICAL PICTURE:
-METAPHYSEAL.
-RADIOLUCENT.
-BONE EXPANSIONTHINNING OF CORTEX

54. SIMPLE BONE CYST

55. ANEURYSEMAL BONE CYST SINGLE. MULTILOCULAR. BLOOD FILLED.
TRAVERSED BY BONE TRABECULAE.
RADIOLOGICAL PICTURE:
-METAPHYSEAL.
-RADIOLUCENT.
-MULTILOCULAR.
-NB: IT RESEMBLE GCT BUT METAPHYSEAL.

56. ANEURYSEMAL BONE CYST

57. OSTEITIS FIROSA CYSTICA
HYPERPARATHYROIDISM INCREASES OSTEOCLASTIC
ACTIVITY WHICH WILL PRODUCE EXCESSIVE BONE
RESORPTION.
EVENTUALLY BONE IS REPLACED BY HIGHLY VASCULAR
FIBROCYSTIC TISSUE.
RADIOLOGICAL PICTURE:
-RESORPTION OF LAMINA DURA OF TOOTH
SOCKETS.
-SUBPERIOSTEAL RESORPTION OF CORTICAL BONE OF SHORT LONG BONES.

58. OSTEITIS FIROSA CYSTICA

59. FIBROUS DYSPLASIA PAGET’S DISEASE
IDIOPATHIC RESORPTION OF BONE  FORMATION OF OSTEOID TISSUE  LASTLY, SCLEROTIC BRITTLE BONE IS FORMED.
RADIOLOGICAL PICTURE:
-RESORPTION.
-DEFORMITY.
-THICKENING.
-NEW BONE FORMATION(GROUND GLASS APPEARANCE)

60. PAGET’S DISEASE