Department of Radiology, University of Szeged. Imaging of the skeleton

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1 Imaging of the skeleton

2 Methods of examination: plain x-ray (radiography, densitometry) x-ray with contrast material (fistulography, angiography) ultrasound (b-mode, Doppler, color, duplex) computed tomography magnetic resonance imaging x-ray-, US-, CT-guided intervention isotope Department of Radiology, University of Szeged

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5 Methods of examination: plain x-ray (radiography, densitometry) x-ray with contrast material (fistulography, angiography) ultrasound (b-mode, Doppler, color, duplex) computed tomography magnetic resonance imaging x-ray-, US-, CT-guided intervention isotope Department of Radiology, University of Szeged

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8 Methods of examination: plain x-ray (radiography, densitometry) x-ray with contrast material (fistulography, angiography) ultrasound (b-mode, Doppler, color, duplex) computed tomography magnetic resonance imaging x-ray-, US-, CT-guided intervention isotope Department of Radiology, University of Szeged

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10 Methods of examination: plain x-ray (radiography, densitometry) x-ray with contrast material (fistulography, angiography) ultrasound (b-mode, Doppler, color, duplex) computed tomography magnetic resonance imaging x-ray-, US-, CT-guided intervention isotope Department of Radiology, University of Szeged

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12 Methods of examination: plain x-ray (radiography, densitometry) x-ray with contrast material (fistulography, angiography) ultrasound (b-mode, Doppler, color, duplex) computed tomography magnetic resonance imaging x-ray-, US-, CT-guided intervention isotope Department of Radiology, University of Szeged

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14 Methods of examination: plain x-ray (radiography, densitometry) x-ray with contrast material (fistulography, angiography) ultrasound (b-mode, Doppler, color, duplex) computed tomography magnetic resonance imaging x-ray-, US-, CT-guided intervention isotope Department of Radiology, University of Szeged

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16 Methods of examination: plain x-ray (radiography, densitometry) x-ray with contrast material (fistulography, angiography) ultrasound (b-mode, Doppler, color, duplex) computed tomography magnetic resonance imaging x-ray-, US-, CT-guided intervention isotope Department of Radiology, University of Szeged

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18 Primary bone changes: change of shape (deformity) change of structure (heteroplasia) change of calcium content increased (osteosclerosis) decreased (atrophy, porosis, malacia) bone necrosis (osteonecrosis) bone destruction (osteolysis) Department of Radiology, University of Szeged

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20 Primary bone changes: change of shape (deformity) change of structure (heteroplasia) change of calcium content increased (osteosclerosis) decreased (atrophy, porosis, malacia) bone necrosis (osteonecrosis) bone destruction (osteolysis) Department of Radiology, University of Szeged

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22 Primary bone changes: change of shape (deformity) change of structure (heteroplasia) change of calcium content increased (osteosclerosis) decreased (atrophy, porosis, malacia) bone necrosis (osteonecrosis) bone destruction (osteolysis) Department of Radiology, University of Szeged

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24 Primary bone changes: change of shape (deformity) change of structure (heteroplasia) change of calcium content increased (osteosclerosis) decreased (atrophy, porosis, malacia) bone necrosis (osteonecrosis) bone destruction (osteolysis) Department of Radiology, University of Szeged

25 Osteoatrophy (Sudeck sy.) Department of Radiology, University of Szeged

26 Osteoporosis Department of Radiology, University of Szeged

27 Rickets (Vitamin D deficiency child) Department of Radiology, University of Szeged

28 Osteomalacia (Vitamin D deficiency adult) Department of Radiology, University of Szeged

29 Primary bone changes: change of shape (deformity) change of structure (heteroplasia) change of calcium content increased (osteosclerosis) decreased (atrophy, porosis, malacia) bone necrosis (osteonecrosis) bone destruction (osteolysis) Department of Radiology, University of Szeged

30 Osteonecrosis (child) Department of Radiology, University of Szeged

31 Osteonecrosis (adult) Department of Radiology, University of Szeged

32 Primary bone changes: change of shape (deformity) change of structure (heteroplasia) change of calcium content increased (osteosclerosis) decreased (atrophy, porosis, malacia) bone necrosis (osteonecrosis) bone destruction (osteolysis) Department of Radiology, University of Szeged

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34 Bone diseases: congenital malformations metabolic diseases sterile necrosis infection primary bone tumor metastasis fracture Department of Radiology, University of Szeged

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36 Bone diseases: congenital malformations metabolic diseases sterile necrosis infection primary bone tumor metastasis fracture Department of Radiology, University of Szeged

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38 Bone diseases: congenital malformations metabolic diseases sterile necrosis infection primary bone tumor metastasis fracture Department of Radiology, University of Szeged

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40 Bone diseases: congenital malformations metabolic diseases sterile necrosis infection primary bone tumor metastasis fracture Department of Radiology, University of Szeged

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44 Bone diseases: congenital malformations metabolic diseases sterile necrosis infection primary bone tumor metastasis fracture Department of Radiology, University of Szeged

45 Classification of primary bone tumors I: reactive lesions and hamartomas benign semimalignant reactive hamartoma osteogenetic osteoma osteochondroma osteoid osteoma chondrogenetic enchondroma myelogenetic collagenetic haemangioma fibroma Department of Radiology, University of Szeged

46 Classification of primary bone tumors II: neoplasms benign semimalignant malignant osteogenetic osteoblastoma osteosarcoma chondrogenetic chondroblastoma chondrosarcoma myelogenetic Ewing sarcoma, myeloma collagenetic osteoclastoma fibrosarcoma Department of Radiology, University of Szeged

47 Indicative signs of bone tumor nature SIGN Benign Malignant growth slow fast contour sharp ill-defined margin calcification + - stroma calcification +/- +/- cortex intact/bulging destroyed periosteum intact invaded/destroyed surroundings intact invaded dissemination - +/- Department of Radiology, University of Szeged

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56 Bone diseases: congenital malformations metabolic diseases sterile necrosis infection primary bone tumor metastasis fracture Department of Radiology, University of Szeged

57 Detection of bone metastases bone scintigraphy + - x-ray stop met. other neg. stop stop MRI Department of Radiology, University of Szeged

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63 Bone diseases: congenital malformations metabolic diseases sterile necrosis infection primary bone tumor metastasis fracture (next semester ) Department of Radiology, University of Szeged

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Primary bone tumors > metastases from other sites Primary bone tumors widely range -from benign to malignant. Classified according to the normal cell

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