|
|
Line 4: |
Line 4: |
| {{Osteosarcoma}} | | {{Osteosarcoma}} |
| ==Overview== | | ==Overview== |
| Plain radiography in primary, posteroanterior (PA), and lateral chest views are necessary. On x-ray, osteosarcoma is characterized by [[medullary]] and [[cortical bone]] destruction, [[periosteal reaction]], tumor matrix [[calcification]], and soft tissue mass.<ref name="radio2">Osteosarcoma. Dr Amir Rezaee ◉ and Dr Frank Gaillard ◉ et al. Radiopaedia.org 2015. http://radiopaedia.org/articles/osteosarcoma</ref>
| | On x-ray, osteosarcoma is characterized by [[medullary]] and [[cortical bone]] destruction, [[periosteal reaction]], tumor matrix [[calcification]], and soft tissue mass.<ref name="radio2">Osteosarcoma. Dr Amir Rezaee ◉ and Dr Frank Gaillard ◉ et al. Radiopaedia.org 2015. http://radiopaedia.org/articles/osteosarcoma</ref> |
|
| |
|
| ==X Ray <ref name="pmid9111202">{{cite journal |vauthors=Yamagishi N, Miyakoshi J, Takebe H |title=Decrease in the frequency of X-ray-induced mutation by wild-type p53 protein in human osteosarcoma cells |journal=Carcinogenesis |volume=18 |issue=4 |pages=695–700 |date=April 1997 |pmid=9111202 |doi= |url=}}</ref><ref name="pmid11972368">{{cite journal |vauthors=Mori K, Sekine N, Sato H, Shimao D, Shiwaku H, Hyodo K, Sugiyama H, Ando M, Ohashi K, Koyama M, Nakajima Y |title=Application of synchrotron X-ray imaging to phase objects in orthopedics |journal=J Synchrotron Radiat |volume=9 |issue=Pt 3 |pages=143–7 |date=May 2002 |pmid=11972368 |doi= |url=}}</ref><ref name="pmid15067366">{{cite journal |vauthors=Takahashi T, Ogawa Y, Kobayashi T, Sonobe H, Seguchi H, Tani T, Yoshida S |title=The role of selective COX-2 inhibitors in reactive oxygen species formation in osteosarcoma cells after X-ray irradiation |journal=Int. J. Mol. Med. |volume=13 |issue=5 |pages=661–4 |date=May 2004 |pmid=15067366 |doi= |url=}}</ref>== | | ==X Ray== |
| Conventional radiography continues to play an important role in diagnosis of osteosarcoma. Typical appearances of conventional high grade osteosarcoma include:<ref name="radio2">Osteosarcoma. Dr Amir Rezaee ◉ and Dr Frank Gaillard ◉ et al. Radiopaedia.org 2015. http://radiopaedia.org/articles/osteosarcoma</ref> | | Conventional radiography continues to play an important role in diagnosis of osteosarcoma. Typical appearances of conventional high grade osteosarcoma include:<ref name="radio2">Osteosarcoma. Dr Amir Rezaee ◉ and Dr Frank Gaillard ◉ et al. Radiopaedia.org 2015. http://radiopaedia.org/articles/osteosarcoma</ref> |
| *[[Medullary]] and [[cortical bone]] destruction. | | *[[Medullary]] and [[cortical bone]] destruction. |
Line 20: |
Line 20: |
|
| |
|
| <gallery perrow="3"> | | <gallery perrow="3"> |
| File:Osteosarcoma-distal-femur.jpg|Osteosarcoma of distal femur<ref name=radio>Image courtesy of Dr Frank Gaillard. [http://www.radiopaedia.org Radiopaedia] (original file [http://radiopaedia.org/cases/osteosarcoma-distal-femur]). http://radiopaedia.org/licence Creative Commons BY-SA-NC</ref> . http://radiopaedia.org/articles/osteosarcoma | | File:Osteosarcoma-of-the-distal-femur.jpg |
| File:Osteosarcoma femur.jpg|Osteosarcoma of distal femur lateral view<ref name=radio>Image courtesy of Dr Frank Gaillard. [http://www.radiopaedia.org Radiopaedia] (original file [http://radiopaedia.org/cases/osteosarcoma-distal-femur]). http://radiopaedia.org/licence Creative Commons BY-SA-NC</ref> . http://radiopaedia.org/articles/osteosarcoma | | File:Osteosarcoma-of-the-distal-femur (1).jpg |
| | File:Pathological-femur-fracture (1).jpg |
| | File:Pathological-femur-fracture.jpg |
| </gallery> | | </gallery> |
|
| |
|
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohammadmain Rezazadehsaatlou[2].
Overview
On x-ray, osteosarcoma is characterized by medullary and cortical bone destruction, periosteal reaction, tumor matrix calcification, and soft tissue mass.[1]
X Ray
Conventional radiography continues to play an important role in diagnosis of osteosarcoma. Typical appearances of conventional high grade osteosarcoma include:[1]
- Sunburst appearance
- Codman triangle
- Lamellated (onion skin) reaction: less frequently seen
- Variable: reflects a combination of the amount of tumor bone production, calcified matrix, and osteoid.
- Ill-defined fluffy or cloud-like cf. to the rings and arcs of chondroid lesions.
- The following table illustrates the findings on x-ray for the subtypes of osteosarcoma:[1]
|
Subtype
|
X-Ray findings
|
- Intracortical osteosarcoma
|
- Presents as an oval intracortical geographic osteolytic lesion in the diaphysis with surrounding sclerosis.
- Measures approximately 4 cm in length.
- Multiple calcific foci can be seen within the lytic region, suggesting osteoid matrix.
|
- Parosteal osteosarcoma
|
- Large lobulated exophytic, 'cauliflower-like' mass with central dense ossification adjacent to the bone.
- String sign: Thin radiolucent line separating the tumor from cortex, observed in 30% of cases.
- Tumor stalk: Grows within tumor in late stages and obliterates the radiolucent cleavage plane.
- +/- soft tissue mass.
- Cortical thickening without aggressive periosteal reaction is often seen.
- Tumor extension into medullary cavity is frequently observed.
|
- Periosteal osteosarcoma
|
- Typically seen as a broad-based surface soft-tissue mass causing extrinsic erosion of thickened underlying diaphyseal cortex and perpendicular periosteal reaction extending into the soft-tissue component.
|
- Telangiectatic osteosarcoma
|
- Typically seen as an expansile lytic metaphyseal bony lesion.
- Geographic bony destruction with wide zone of transition tends to be more common than permeative bony destruction.
- Less osteoid matrix compared from conventional type.
|
- Low grade osteosarcoma
|
- Because the fibrous dysplasia and central low-grade osteosarcoma are so similar histologically, the radiographic features are an extremely important part of the diagnosis.
- Radiographic features of low grade osteosarcomas are variable.
- Most common pattern is as a large intracompartmental expansile lytic fibro-osseous lesion with coarsely thick or thin incomplete trabeculations. Another less common pattern is as a dense sclerotic lesion.
- Cortical erosion and soft tissue extension is also a common feature.
|
- Extra skeletal osteosarcoma
|
- Soft tissue density with variable amount of calcification which represents osteoid matrix formation, and is seen in approximately 50% of cases.
|
References
Template:WH
Template:WS