Top

International Orthopaedics

Published in:

01-05-2013 | Review article

Musculoskeletal tumors and tumor-like conditions: common and avoidable pitfalls at imaging in patients with known or suspected cancer

Part A: benign conditions that may mimic malignancy

Authors: Gary Ulaner, Sinchun Hwang, Robert A. Lefkowitz, Jonathan Landa, David M. Panicek

Published in: International Orthopaedics | Issue 5/2013

Abstract

A wide range of musculoskeletal tumors and tumor-like conditions may be encountered when patients undergo radiological examinations. The imaging features of certain normal, reactive, benign neoplastic, inflammatory, traumatic, and degenerative processes in the musculoskeletal system may mimic malignant tumor; misinterpretation of the imaging findings can lead to inappropriate clinical management of the patient. This review describes and illustrates a number of such mimics that we have commonly encountered in our oncological imaging practice, and provides suggestions for avoiding each of these pitfalls. Because many orthopaedic surgeons interpret radiological images themselves, they need to be as aware as radiologists about these issues.

Cronin CG, Cashell T, Mhuircheartaigh JN, Swords R, Murray M, O’Sullivan GJ, O’Keefe D (2009) Bone biopsy of new suspicious bone lesions in patients with primary carcinoma: prevalence and probability of an alternative diagnosis. AJR Am J Roentgenol 193:W407–W410PubMedCrossRef

Toomayan GA, Major NM (2011) Utility of CT-guided biopsy of suspicious skeletal lesions in patients with known primary malignancies. AJR Am J Roentgenol 196:416–423PubMedCrossRef

Stacy GS, Dixon LB (2007) Pitfalls in MR image interpretation prompting referrals to an orthopedic oncology clinic. RadioGraphics 27:805–828PubMedCrossRef

Kransdorf MJ, Meis JM, Jelinek JS (1991) Myositis ossificans: MR appearance with radiologic-pathologic correlation. AJR Am J Roentgenol 157:1243–1248PubMedCrossRef

Naylor MF, Nascimento AG, Sherrick AD, McLeod RA (1996) Elastofibroma dorsi: radiologic findings in 12 patients. AJR Am J Roentgenol 167:683–687PubMedCrossRef

Onishi Y, Kitajima K, Senda M, Sakamoto S, Suzuki K, Maeda T, Yoshikawa T, Ohno Y, Sugimura K (2011) FDG PET/CT imaging of elastofibroma dorsi. Skeletal Radiol 40:849–853PubMedCrossRef

Flemming DJ, Murphey MD, Shekitka KM, Temple HT, Jelinek JJ, Kransdorf MJ (2003) Osseous involvement in calcific tendinitis: a retrospective review of 50 cases. AJR Am J Roentgenol 181:965–972PubMedCrossRef

Dinter DJ, Neff WK, Klaus J, Bohm C, Hatks J, Weiss C, Schoenberg SO, Metzgeroth G (2009) Comparison of whole-body MRI imaging and conventional X-ray examination in patients with multiple myeloma and implications for therapy. Ann Hematol 88:457–464PubMedCrossRef

Richardson ML, Patten RM (1994) Age-related changes in marrow distribution in the shoulder: MR imaging findings. Radiology 192:209–215PubMed

10.

Lang P, Fritz R, Majumdar S, Vahlensieck M, Peterfy C, Genant HK (1993) Hematopoietic bone marrow in the adult knee: spin-echo and opposed-phase gradient-echo MR imaging. Skeletal Radiol 22:95–103PubMedCrossRef

11.

Hwang S, Panicek DM (2007) Magnetic resonance imaging of bone marrow in oncology, Part 1. Skeletal Radiol 36:913–920PubMedCrossRef

12.

Salavati A, Shah V, Wang ZJ, Yeh BM, Costouros NG, Coakley FV (2011) F-18 FDG PET/CT findings in postradiation pelvic insufficiency fracture. Clin Imaging 35:139–142PubMedCrossRef

13.

Tsuchida T, Kosaka N, Sugimoto K, Itoh H (2006) Sacral insufficiency fracture detected by FDG-PET/CT: report of 2 cases. Ann Nucl Med 20:445–448PubMedCrossRef

14.

Cetik O, Uslu M, Ozsar BK (2007) The relationship between Hill-Sachs lesion and recurrent anterior shoulder dislocation. Acta Orthop Belg 73:175–178PubMed

15.

Nakamoto Y, Cohade C, Tatsumi M, Hammoud D, Wahl RL (2005) CT appearance of bone metastases detected with FDG PET as part of the same PET/CT examination. Radiology 237:627–634PubMedCrossRef

16.

Fink-Bennett DM, Shapiro EE (1984) The Angle of Louis. A potential pitfall ("Louie’s Hot Spot") in bone scan interpretation. Clin Nucl Med 9:352–354PubMedCrossRef

17.

Puig S, Staudenherz A, Steiner B, Eisenhuber E, Leitha T (1998) Differential diagnosis of atypically located single or double hot spots in whole bone scanning. J Nucl Med 39:1263–1266PubMed

18.

Aoki J, Watanabe H, Shinozaki T, Takagishi K, Ishijima H, Oya N, Sato N, Inoue T, Endo K (2001) FDG PET of primary benign and malignant bone tumors: standardized uptake value in 52 lesions. Radiology 219:774–777PubMed

19.

Llauger J, Palmer J, Rosón N, Cremades R, Bagué S (1999) Pigmented villonodular synovitis and giant cell tumors of the tendon sheath: radiologic and pathologic features. AJR Am J Roentgenol 172:1087–1091PubMedCrossRef

20.

Iagaru A, Henderson R (2006) PET/CT follow-up in nonossifying fibroma. AJR Am J Roentgenol 187:830–832PubMedCrossRef

21.

Goodin GS, Shulkin BL, Kaufman RA, McCarville MB (2006) PET/CT characterization of fibroosseous defects in children: 18F-FDG uptake can mimic metastatic disease. AJR Am J Roentgenol 187:1124–1128PubMedCrossRef

Title: Musculoskeletal tumors and tumor-like conditions: common and avoidable pitfalls at imaging in patients with known or suspected cancer
Part A: benign conditions that may mimic malignancy
Authors: Gary Ulaner
Sinchun Hwang
Robert A. Lefkowitz
Jonathan Landa
David M. Panicek
Publication date: 01-05-2013
Publisher: Springer-Verlag
Published in: International Orthopaedics / Issue 5/2013
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-013-1823-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Musculoskeletal tumors and tumor-like conditions: common and avoidable pitfalls at imaging in patients with known or suspected cancer

Part A: benign conditions that may mimic malignancy

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 5/2013

Biomechanical comparison of different fixation techniques for reconstruction of tibial avulsion fractures of the anterior cruciate ligament

Kinematic factors affecting postoperative knee flexion after cruciate-retaining total knee arthroplasty

Comment on Bao et al.: Lesser trochanteric osteotomy in total hip arthroplasty for treating CROWE type IV developmental dysplasia of hip

Blood perfusion and bone formation before and after minimally invasive periacetabular osteotomy analysed by Positron Emission Tomography combined with Computed Tomography

Comment on Hernigou and Schuind: smoking as a predictor of negative outcome in diaphyseal fracture healing

Smoking as a predictor of negative outcome in diaphyseal fracture healing