plain xray findings

1. Dr Sharan Hongal

3.  Eccentric bony outgrowth from metaphyseal region of long bone
 Composed of cortical and medullary portion which are continuous with underlying
bone
 Attachment
 Sessile
 Pedunculated

5.  Small, Well demarcated, Lobulated translucent lesion with cortical thinning, bony
expansion and variable amount of intralesional stippled calcification which may
appear as RINGS and ARCS like densities
 Periosteal reaction, cortical erosion and reactive bone formation are absent
 Lesion length is less than 6 cm

7.  Faintly outlined, lightly calcified, small , ovoid contoured soft tissue mass lying
external to and directly contiguous with the cortex
 Cortical scalloping with / without sclerosis, thin periosteal shell, chondroid matrix
mineralization and rarely intramedullary invasion
 Sometimes minor cortical elevation with a buttress type of periosteal reaction

9.  Well defined lytic area adjacent to epiphyseal line with its epicentre common in
epiphysis but rare in metaphysis
 Thin, lobulated sclerotic margin
 Lesion may cross groth plate and enter meta or epiphysis
 30 % cases show matrix mineralization due to calcium deposit
 Metaphyseal lesion show periosteal reaction with reactive bone formation

11.  Lesions are eccentric, geographic with narrow zone of transition, sclerosis and
scalloping towards inner which appear like BITE LIKE destruction
 On outer cortex is thinned out and may be associated with mild expansion or break in
cortex with extra osseous soft tissue component
 They show internal trabeculation without obvious matrix
 In narrow tubular bone they appear like fusiform expansion

13.  Round to lobular , 3-4 cm
homogenous radio dense mass
with smooth contour on the
cortical surface without cortical
invasion or cortical and medullar
continuity with the host bone

14.  Long bone appear as a solitary
small rarefied lesion , les than 2
cm in diameter in either the
cortex, sub cortical or
subperiosteal region
 Surrounded by thickened and
sclerotic bone with varying
amounts of calcification in the
nidus

15.  Vairies and depends on the size,
location and degree of ossification
 Typically it appear as radiolucent or
mottled, well circumcised lesion with
variable amount of ossification and a
thin peripheral shell of reactive bone

16.  Lytic lesion centered in the epiphysis but involving metaphysis and extending at least
in part close to subchondral bone
 Tumor usually bulges beyond the confines of cortex which has undergone varing
degree of resorption
 No periosteal reaction
 Multiple septa traverse the interior and produce a characterstic lobulated SOAP-
BUBBLE appearance

18.  Lesion will appear well defined, oval
lytic lesion arising eccentrically in the
metaphyseal cortex of long bone with
long axis parallel to the axis of the
bone
 Surrounded with a thin sclerotic rim
which is deficient on external side of
lesion

19.  Well defined , intracortical lytic
lesion surrounded by sclerosis
 It involves anterior cortex and
multiple lucencies
 Associated with anterior tibia
bowing

20.  Eccentrically placed, well defined
osteolytic, multiloculated , expansile
lesion in the anterior diaphysis of the
tibia with marginal sclerosis and a
variable degree of intralesional
septation and opacities
 Large or recurrent lesions may
demonstrate cortical destruction and
extension into medullary canal and
extraosseous soft tissue

21.  Well defined , expansile, medullary
lesion in metaphysis or diaphysis with
or without endosteal scalloping and
showing translucency
 Canal is Replaced with fibrous tissue
characterized by delicate woven bone
spicules that give the tissue
GROUND GLASS appearance

22.  Large, wll localized radiolucent,
expansile lesion with narrow zone of
transition and no matrix
 Lesion situated in juxta-epiphyseal
portion of the metaphysis but can
sometimes be at a distance from the
growth plate
 Sometimes fragment of fractured cyst
wall is found fallen into the fluid cavity
FALLEN LEAF

23.  Centrally or eccentrally placed
ballooned out, well defined lytic lesion
without matrix and with a thin shell of
reactive periosteal bone

24.  Variable mixture of radio opacities of osteogenesis and radiolucencies due to
destructive changes and replacement with osteoid tissue
 Changes are initially seen at metaphysis situated eccentrally and outgrowing from
canal to extra skeletal region
 Shows aggressive features permeative growth patterns, indistinct margins , cortex
erosion
 Newly formed tumor tissue which has not reached its full osteogenic potential and
therefore less opaque as it extends beyond the cortex and periosteum

25.  Fine lines if increased density,
representing newly formed spicules of
bone, radiate laterally from and at right
angles to the surface of shaft giving
typical SUNBURST appearance
 As the periosteum is elevated, a triangle
of reactive periosteal ossification
produces triangular radio opacity at
upper and lower angles

26.  Non matrix producing destructive
lesion in the metadiaphysis and
diaphysisof long bone with an
aggressive periosteal reaction
described as ONION PEEL ,though
codmans triangle may be seen

27.  An expansion of the medullary portion the
bone and thickening of the cortex but
periosteal reaction is absent
 Endosteal scalloping as well as annular,
punctate or comma shaped stippled
calcification
 Endosteal scalooping of more than two
third of cortical thickness is suggestive of
more aggressive lesion

28.  Midline lesion and often appear as
destructive bone lesion with epicetre in
the vertebral body and a surrounding
tissue mass