By Francis Burgener
The normal x-ray is still a cheap, first-line modality for the diagnostic imaging of the bones and joints. during this re-creation of this vintage, crucial assistance is supplied to make initial diagnoses of an enormous diversity of stipulations effecting the musculoskeletal process. The differential diagnostic info is supplied in tables, prepared by way of periods of findings, and illustrated through greater than a thousand exceptional radiographs and, the place priceless, schematic diagrams. Read more...
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Extra info for Bone and joint disorders: differential diagnosis in conventional radiology
Solid periosteal reactions can be thin (1 mm or less in thickness) or thick (2 mm or more). A thin periosteal reaction might represent an early stage of a highly aggressive bone lesion or a chronic, benign process (Fig. 1). On the other hand, a thick periosteal reaction usually suggests a benign condition. Thick periosteal reactions may be further subdivided into straight, elliptical, and undulating, each subtype suggesting somewhat different diagnostic possibilities (Fig. 2). An interrupted periosteal reaction, in general, signals an acute and rapidly progressing process requiring immediate Fig.
A dense, elliptical periosteal reaction with a nidus (arrow) is diagnostic. 47 Fig. 19 Neuroblastoma metastasis. A permeative lesion with a Codman’s triangle (arrow) and a faint perpendicular periosteal reaction is seen. A solitary neuroblastoma metastasis is radiographically often indistinguishable from a Ewing’s sarcoma. Fig. 22 Acute osteomyelitis. A destructive bone lesion surrounded by a laminated periosteal reaction is seen. ) Diseases with Periosteal Reactions Disease Preferred Locations Chronic osteomyelitis (Fig.
30) Can present with focal or diffuse bone involvement. Focal form is characterized by scattered, well-defined sclerotic foci often alternating with areas of bone rarefaction. Skull, spine, ribs, pelvis, humerus, and femur are preferred sites of involvement. Majority of patients develop skin lesions containing mast cells during the first year of life. Hepatosplenomegaly, lymphadenopathy, and pancytopenia may be associated. (continues on page 26) 2 Osteosclerosis 25 Fig. 26 Radiation osteonecrosis.