Radiology- Boards Review

4. Epiphysis:
 Pediatric (<20): Chondroblastoma
 Adult: Giant cell tumor (GCT)
 Other differentials:
 Osteomyelitis,
 Paget disease

5.  Medullary:
 Simple (unicameral) bone
cyst
 Aneurysmal
(multicameral) bone cyst
 Enchondroma
 Fibrous dysplasia
 Chondromyxoid fibroma
 Conventional
osteosarcoma
 Chondrosarcoma
 Osteochrondroma (most
common benign bone
tumor)
 Cortical:
 Fibrous cortical defect
(FCD)
 Non-ossifying fibroma
(NOF)
 Osteoid osteoma
 Juxtacortical:
 Juxtacortical chondroma
 Periosteal osteosarcoma
 Paraosteal osteosarcoma
 Juxtacortical
chondrosarcoma

6.  Osteoma - Skull
 Osteoid Osteoma/ Osteoblastoma
 Osteosarcoma
 Osteochondroma
 Chondroma
 Enchondroma
 Chondroblastoma
 Chondrosarcoma
 Ewing Sarcoma
 Giant CellTumor
 Fibrous Dysplasia
 Non ossifying fibroma
 Aneurysmal bone cyst
 Unicameral bone cyst

7.  Radiolucent nidus with sclerotic
border or vice versa, well-demarcated
 Metaphysis, Diaphysis
 Children/Adolescent
 Painful – relieved by NSAIDs/Aspirin
 Grossly “cherry red” nidus
 <2.0cm, if >2.0cm  Osteoblastoma
 Numbers vary depending on source

8.  Radiodense lesion with cortical
lifting Codman’s triangle or
“sunburst” appearance
 Metaphysis most common-
knee
 Rapid growth during adolescence-
teenager
 Pain, swelling, pathological fx
 Age: <20 y/o most and then >60
y/o peak
 Most common primary
malignant tumor young
adults

9.  Most common benign
osseous tumor in lower
limb
 Mushroom looking
exostosis
 Metaphysis region near
epiphyseal plate 
juxta cortical
 Young males- 10-30

10.  Radiolucent expansile lesion, can
calcify
 Metaphysis
 Can become malignant*, painless
but can present as swelling
 Enchondroma if arises from
medullary cavity
 Ollier’s – Multiple systemic
enchondromatosis (malignant)
 Maffucci’s – Ollier’s +
phleboliths/calcified
hemangiomas
 Most common benign osseous
tumor digits

11.  Radiolucent with
calcifications
 Epiphysis
 Children/Adolescent
 Growth plate open

12.  Radiodense with
calcifications, usually
located at surface of
bone
 Any location- hips,
pelvis, shoulder
 Adults
 Progressively painful

13.  Radiodensity with “onion-
skinning” of the periosteum
with cortical erosion
 Diaphysis of long bones
 Children/Adolescent
 Pain, swell, possible fever and
leukocytosis
 Most common primary
malignant tumor teenagers.
 chromosome translocation
11-22

14.  Aka Osteoclastoma
 Origin: osteoclasts
 Radiolucent multilocular
“soap bubble”
 Epiphysis to metaphysis of
long bones
 Wrist and knee joints
 Distal femur and proximal
tibia
 Adults- 20-55

15.  Radiolucent with
microcalcifications
 Metaphysis, Diaphysis
 Children/Adolescent
 Asymptomatic
 “Ground glass”
appearance

16.  Radiolucency that is
multilocular
 Metaphysis, usually at cortical
edges
 Children/Adolescent
 Almost all resolve
spontaneously, if not  Non-
ossifying fibroma

17.  Radiolucent, “blow-out”
appearance expansile
 Metaphysis
 Any age
 Vascular painful, grossly
red-brown, hot on bone
scan
 “Finger in balloon sign”
cortex intact

18.  Radiolucent well-
demarcated, non-
expansile
 Metaphysis
 Children/Adolescent
 Sanguinous fluid-filled,
asymptomatic
 “Falling fragment sign”
 Pathologic fracture

19.  Radiodense cortical
bone within cancellous
bone well-demarcated
 Any location
 Any age
 Multiple enostoses 
Osteopoicholosis may
have hypertrophic or
keloid scar formation

20.  Radiodense
calcifying soft tissue
 Any location
 Any age
 Trauma-induced,
growth from
periphery to center

21.  Radiodense
increasing size
 Any location
 Any age
 No hx trauma,
grows from center
to periphery

22.  Radiodense lytic lesions
 Any location
 Any age but more
common adults
 Commonly from
Prostate, Breast,
Kidney,Thyroid, Lungs,
Multiple Myeloma
(most common
primary malignant
bone tumor all ages)

23.  Chondromyxoid Fibroma
 Ecchondromas
 Interosseous lipoma
 Fibrosarcoma
 Osteoma (similar to osteochondroma
without cartilage cap)

24.  Paget’s/Ricket’s Flame shaped, Blades of grass
 Ricket’s widened physis and ant. bowing
 Osteopoikilosis  bone islands
 Osteopetrosis  bone on bone; marble bone disease;
stone bone
 Non-ossifying fibroma  bubbly; long lytic lesion in
long bone
 Melorheostosis  melted candle wax