Adult leukemia patients experience radiographic bone changes less than 20% of the time due to most bone marrow being fatty rather than red in adults. The major bone features seen in both children and adults with leukemia include diffuse bone loss, radiolucent bands below the growth plate, lytic bone destruction, and periosteal bone formation. Diffuse osteoporosis is often the first finding seen in the spine.

1. ADULT LEUKEMIA
Radiographic osseous changes occur
in < 20% of adult leukemia patients
owing to the predominance of fatty
rather than red marrow in the adult
skeleton. As in the childhood forms,
the major features include diffuse
osteoporosis, radiolucent
submetaphyseal bands, lytic
destruction, and periosteal
response. In the spine the diffuse
osteoporosis is frequently the initial
finding.