engleski

Skeletal "don't touch" lesions

Learning objectives: The aim of this poster is to present radiographically typical skeletal "don't touch" lesions ( also known as "leave me alone" lesions ) that do not require additional diagnostic exploration for the final radiologic diagnosis. With that in mind, further action to distinguish the nature of the lesion, such as biopsy, is needles and inappropriate. Background: These lesions can be divided into three subcategories. 1. Post-traumatic lesions: myositis ossificans, avulsion injury, cortical desmoid, traumatic cystic geodes / subchondral cysts, discogenic vertebral sclerosis, fracture mimicking tumour (with extensive osteosclerosis and periostitis), pseudodislocation of the humerus and costochondritis / Tietze's syndrome. 2. Normal variants: dorsal defect of the patella, pseudocyst of the humerus and os odontoideum. 3. Real lesions which are obviously benign: nonossifying fibroma, bone islands / enostosis ( insula compacta ), unicameral bone cysts ( pseudotumour of the calcaneus ), bone infarction, osteopoikilosis, synovial herniation pit ( pitt's pit ), vertebral hemangioma, chondromyxoid fibroma ( CMF ), liposclerosing myxofibrous tumour (LSMFT), vertebral haemangioma ( primary intraosseous haemangioma ) and enchondroma ( Ollier disease and Maffucci syndrome ) Findings and procedure details: Imaging techniques used for the radiological, as well as the final medical diagnosis are digital radiography, CT, MRI. Conclusion: Often misleading additional diagnostic tests could lead not only to unnecessary surgical removal and postponed diagnosis of the lesion, but also to unwanted morbidity and cost. In addition, due to the radiographically highly distinctive features, radiologists should be able to identify previously mentioned lesions as benign without considering further histological verification.

musculoskeletal; benign; lesion; imaging

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