Semin Musculoskelet Radiol 2020; 24(03): 203-213
DOI: 10.1055/s-0040-1708873
Review Article

Ten Commandments for the Diagnosis of Bone Tumors

1   Department of Imaging, Royal Orthopaedic Hospital, Birmingham, United Kingdom
,
2   Department of Imaging, Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, United Kingdom
,
Klaus Woertler
3   Department of Imaging, Technische Universitat Munchen, Munich, Germany
,
Johan L. Bloem
4   Department of Imaging, Leiden University Medical Center, Leiden, The Netherlands
,
Gunnar Åström
5   Department of Immunology, Genetics and Pathology (Oncology) and Department of Surgical Sciences (Radiology), Uppsala University Hospital, Uppsala, Sweden
› Author Affiliations

Abstract

The diagnosis of tumors and tumorlike lesions of bone is a routine part of both general and specialist radiologic practices. The spectrum of disorders ranges from the small incidental lesion to the potentially life-limiting malignancies whether primary or secondary. In this review, authored by experts from several European orthopaedic oncology centers, we present a collection of pieces of advice in the form of 10 commandments. Adherence in daily practice to this guidance should help minimize adverse patient experiences and outcomes.

Supplementary Material



Publication History

Article published online:
28 September 2020

© 2020. Thieme. All rights reserved.

Thieme Medical Publishers
333 Seventh Avenue, New York, NY 10001, USA.

 
  • References

  • 1 Ardran GM. Bone destruction not demonstrable by radiography. Br J Radiol 1951; 24 (278) 107-109
  • 2 Lodwick GS. Reactive response to local injury in bone. Radiol Clin North Am 1964; 2: 209-219
  • 3 Brady AP. Error and discrepancy in radiology: inevitable or avoidable?. Insights Imaging 2017; 8 (01) 171-182
  • 4 Edeiken J. Roentgen Diagnosis of Diseases of Bone. Baltimore, MD: Williams and Wilkins; 1981: 8-32
  • 5 Kricun ME. Radiographic evaluation of solitary bone lesions. OrthopClin North Am 1983; 14 (01) 39-64
  • 6 Miller TT. Bone tumors and tumorlike conditions: analysis with conventional radiography. Radiology 2008; 246 (03) 662-674
  • 7 Madewell JE, Ragsdale BD, Sweet DE. Radiologic and pathologic analysis of solitary bone lesions. Part I: internal margins. Radiol Clin North Am 1981; 19 (04) 715-748
  • 8 Ragsdale BD, Madewell JE, Sweet DE. Radiologic and pathologic analysis of solitary bone lesions. Part II: periosteal reactions. Radiol Clin North Am 1981; 19 (04) 749-783
  • 9 Sweet DE, Madewell JE, Ragsdale BD. Radiologic and pathologic analysis of solitary bone lesions. Part III: matrix patterns. Radiol Clin North Am 1981; 19 (04) 785-814
  • 10 Rosenberg ZS, Lev S, Schmahmann S, Steiner GC, Beltran J, Present D. Osteosarcoma: subtle, rare, and misleading plain film features. AJR Am J Roentgenol 1995; 165 (05) 1209-1214
  • 11 Wilcox Jr JR. The meaning of words. Radiology 1998; 208 (03) 829-830
  • 12 Davies AM, Cassar-Pullicino VN. Principles of detection and diagnosis. In: Davies AM, Sundaram M, James SLJ. , ed. Imaging of Bone Tumors and Tumor-like Lesions: Techniques and Applications. Berlin, Germany: Springer; 2009: 111-137
  • 13 Ruatta F, Derosa L, Escudier B. , et al. Prognosis of renal cell carcinoma with bone metastases: experience from a large cancer centre. Eur J Cancer 2019; 107: 79-85
  • 14 López C, Thomas DV, Davies AM. Neoplastic transformation and tumour-like lesions in Paget's disease of bone: a pictorial review. EurRadiol 2003; 13 (Suppl. 04) L151-L163
  • 15 Bazire L, Xu H, Foy JP. , et al. Pelvic insufficiency fracture (PIF) incidence in patients treated with intensity-modulated radiation therapy (IMRT) for gynaecological or anal cancer: single-institution experience and review of the literature. Br J Radiol 2017; 90 (1073): 20160885
  • 16 Sapienza LG, Salcedo MP, Ning MS. , et al. Pelvic insufficiency fractures after external beam radiation therapy for gynaecologic cancers: a meta-analysis and meta-regression of 3929 patients. Int J RadiatOncolBiolPhys 2020; 106 (03) 475-484
  • 17 Mani N, Slevin N, Hudson A. What Three Wise Men have to say about diagnosis. BMJ 2011; 343: d7769
  • 18 Kural C, Ugras AA, Sungur I, Ozturk H, Erturk AH, Unsaldi T. Hydatid bone disease of the femur. Orthopedics 2008; 31 (07) 712-713
  • 19 Gould CF, Ly JQ, Lattin Jr GE, Beall DP, Sutcliffe III JB. Bone tumor mimics: avoiding misdiagnosis. CurrProblDiagnRadiol 2007; 36 (03) 124-141
  • 20 Vanel D, Ruggieri P, Ferrari S. , et al. The incidental skeletal lesion: ignore or explore?. Cancer Imaging 2009; 9 Spec No A (01) S38-S43
  • 21 Dumitriu DI, Menten R, Clapuyt P. Pitfalls in the diagnosis of common benign bone tumours in children. Insights Imaging 2014; 5 (06) 645-655
  • 22 READ: Radiology Events and Discrepancies. 18th ed.. London, UK: Royal College of Radiologists; ; March 2018
  • 23 Resnick D, Cone III RO. The nature of humeral pseudocysts. Radiology 1984; 150 (01) 27-28
  • 24 Shimal A, Davies AM, James SLJ, Grimer RJ. Fatigue-type stress fractures of the lower limb associated with fibrous cortical defects/non-ossifying fibromas in the skeletally immature. ClinRadiol 2010; 65 (05) 382-386
  • 25 Ghazizadeh S, Foss EW, Didier R, Fung A, Panicek DM, Coakley FV. Musculoskeletal pitfalls and pseudotumours in the pelvis: a pictorial review for body imagers. Br J Radiol 2014; 87 (1042): 20140243
  • 26 Oudjhane K, Azouz EM. Imaging of osteomyelitis in children. Radiol Clin North Am 2001; 39 (02) 251-266
  • 27 Chamberlin K, Orfanos S, Mukherjee A, Moy E, Koganti M, Khan W. A case of disseminated tuberculosis mimicking metastatic cancer. Respir Med Case Rep 2018; 25: 239-241
  • 28 Suh JS, Cho JH, Shin KH. , et al. MR appearance of distal femoral cortical irregularity (cortical desmoid). J Comput Assist Tomogr 1996; 20 (02) 328-332
  • 29 Kohl CA, Chivers FS, Lorans R, Roberts CC, Kransdorf MJ. Accuracy of chemical shift MR imaging in diagnosing indeterminate bone marrow lesions in the pelvis: review of a single institution's experience. Skeletal Radiol 2014; 43 (08) 1079-1084
  • 30 Douis H, Davies AM, Jeys L, Sian P. Chemical shift MRI can aid in the diagnosis of indeterminate skeletal lesions of the spine. EurRadiol 2016; 26 (04) 932-940
  • 31 Douis H, Davies MA, Sian P. The role of diffusion-weighted MRI (DWI) in the differentiation of benign from malignant skeletal lesions of the pelvis. Eur J Radiol 2016; 85 (12) 2262-2268
  • 32 Utsunomiya D, Shiraishi S, Imuta M. , et al. Added value of SPECT/CT fusion in assessing suspected bone metastasis: comparison with scintigraphy alone and nonfused scintigraphy and CT. Radiology 2006; 238 (01) 264-271
  • 33 Patel A, Davies AM, Botchu R, James S. A pragmatic approach to the imaging and follow-up of solitary central cartilage tumours of the proximal humerus and knee. ClinRadiol 2019; 74 (07) 517-526
  • 34 Fletcher CDM, Bridge JA, Hogendoorn PCW, Mertens F. WHO Classification of Tumours of Soft Tissue and Bone. Lyon, France: International Agency for Research on Cancer; 2013: 235-393
  • 35 Afonso PD, Isaac A, Villagrán JM. Chondroid tumors as incidental findings and differential diagnosis between enchondromas and low-grade chondrosarcomas. SeminMusculoskeletRadiol 2019; 23 (01) 3-18
  • 36 Chalian M, Del Grande F, Thakkar RS, Jalali SF, Chhabra A, Carrino JA. Second-opinion subspecialty consultations in musculoskeletal radiology. AJR Am J Roentgenol 2016; 206 (06) 1217-1221
  • 37 Rozenberg A, Kenneally BE, Abraham JA. , et al. Clinical impact of second-opinion musculoskeletal subspecialty interpretations during a multidisciplinary orthopaedic oncology conference. J Am CollRadiol 2017; 14 (07) 931-936
  • 38 Rozenberg A, Kenneally BE, Abraham JA. , et al. Second opinions in orthopedic oncology imaging: can fellowship training reduce clinically significant discrepancies?. Skeletal Radiol 2019; 48 (01) 143-147