Key Radiographic Findings
1-Cortical destruction, 2-Periostitis, 3-Zone of transition
1-No cortical destruction
2-Benign periostitis: thick wavy, uniform or dense = low-grade chronic irritation
3-Narrow zone of transition; can be traced with a pencil
2-Aggressive periostitis: lamellated (onion-skinned), amorphous, sunburst
3- Wide zone of transition; imperceptible
- Permeative lesions (multiple small holes): not easily categorized as benign vs malignant: multiple myeloma, primary lymphoma of bone, Ewing's sarcoma
See BoneTumor.org for Tumor info
Metastatic Bone Disease
- Bickels J, JBJS 2009;91A:1503
- Biermann S, JBJS 2009;91A:1518
- Mazabraud Syndrome: fibrous dysplasia and intramuscular myxomas. Rarely can develop osteosarcoma. (Crawford EA, JBJS 2009;91A:955
- Klippel-Trenaunay Syndrome: rare congenital disorder characterized by the triad of cutaneous capillary malformation, varicose veins, and hypertrophy of bone and soft tissue (Kihiczak GG, Int J Dermatol 2006;45:883).
- Morquio Disease (MPS IV): autosommal-recessive defect in the activity of one of two enzymes, N-acetylgalactosamine-6-sulfate (MPS-IVA_ or beta-galactosidase (MPS IVB); results in the accumulation of keratan sulfate and chondroitin-6 sulfate (Montano AM, J Inherit Metab Dis 2007;30:165).
- Fibrodysplasia Ossificans Progressiva: rare; disabling autosomal dominant disorder of joint malformation and progressive heterotopic ossification caused by a recurrent missense point mutation in activin receptor IA (ACVRI / ALK2 / a BMP type I receptor). (Moore R, JBJS 2009;91A:1497).