Pictorial Essay – Benign and Malignant Bone Tumors: Radiological Diagnosis and Imaging Features

This paper shows how the simultaneous use of multipurpose loop coils in MRI allows high-resolution musculoskeletal studies with increased contrast and specificity for assessing muscles, tendons, ligaments, joints, and cartilage. Dr. Ferrer presents a number of different daily patient routine examinations, including specifically evaluation of the carpal bones, the thumb metacarpals, the metacarpals, the distal inter-phalangeal joints, the elbow and ankle. [...]

Bone and Soft Tissue Tumor Imaging: An Overview

Tumor imaging can be daunting, given the high stakes involved with a missed diagnosis or mis-diagnosis resulting in unnecessary further investigations, biopsies or even surgeries. In their article Marcus Pianta, Mark Lourensz et al. (St. Vincent’s Hospital, Fitzroy, Australia) describe their routine imaging protocol targeted to bone and soft tissue lesions, describe reporting and what the referring physicians need to know. [...]

Metastatic Melanoma

This 36-year-old patient presented in December 2006 with a suspicious mole on the right lower leg which was surgically removed. Histopathology demonstrated a malignant melanoma. 2.5 years later the patient presented with an inguinal lymph node metastasis on the right side detected on lymph node dissection. MRI was ordered to further evaluate the right leg on which additional cutaneous lesions were noted. [...]

Liposarcoma

This 64 year old man presented to his primary care physician complaining of hematuria. On MR examination, a mass was found in his left upper groin which was confirmed to be a liposarcoma on subsequent biopsy. [...]

Myxoid Chondrosarcoma

This 65-year-old man presented to clinic with a tender mass in the anteromedial portion of his right midthigh which had enlarged over a year’s time. He further complained of nonspecific associated symptoms, including paresthesias and occasional temperature changes in his right leg. Following the illustrated MR examination, the patient was referred for evaluation by surgical oncology. [...]

Nonossifying Fibroma

This 23-year-old woman presented to clinic complaining of right thigh pain over the last year, worse with weightbearing and at night. The subsequent plain film radiograph and MR examination revealed a lesion within the distal femoral metadiaphysis. Biopsy showed findings consistent with a nonossifying fibroma. [...]

Tenosynovial Giant-cell Tumor

This 28-year-old woman presented with an approximately 3 year history of slowly-progressive left ankle pain, worse with movement and at the end of the day. After detection of the illustrated mass, surgery was performed with pathologic examination confirming a tenosynovial giant-cell tumor. [...]

Synovial Sarcoma (monophasic fibrous type)

This 20-year-old man presented with increasing pain and swelling in his left shoulder—an ongoing problem for the prior three months. Physical exam revealed a slightly tender, indurated mass with normal overlying skin. [...]

Ewing Sarcoma

This 15-year-old young boy presented clinically with a complaint of slow onset of a temporal headache, with subsequently vomiting which being serious in the last several weeks. After a physical exam that revealed swelling in the region of the right temporal bone with local tenderness, the patient was referred for a MR exam and received subsequent surgical treatment. [...]

Liposarcoma

This 56 year old man presented to clinic complaining of a mass within the musculature of his medial right thigh that had appeared approximately 5 months ago. The patient denied any associated pain or tenderness. On the illustrated MR examination, a mass was found which was confirmed as a liposarcoma by pathologic evaluation following its surgical removal [...]

Neurofibroma

This 35-year-old female presented to clinic complaining of pain and swelling posterior to her right knee of approximately 3 months duration. Physical examination confirmed the presence of a soft tissue mass in the patient’s right posterior lower leg. An MRI scan demonstrated a well-defined oval lesion, confirmed to be a neurofibroma by subsequent surgery. [...]

Ollier Disease

This 17-year-old girl initially presented as a toddler and has since suffered from multiple complications related to Ollier disease, particularly in regard to her left femur. Disease involvement initially also included the left hemipelvis. The patient subsequently underwent multiple procedures involving the femur for the correction of pathologic fractures and leg-length discrepancies. Her most recent surgery, one year ago, consisted of curettage and bone grafting of lesions in her left iliac wing and proximal femur. [...]

Osseous Lymphoma

This 92-year-old female presented to clinic with chronic right shoulder swelling and pain of several months duration which had become more severe in last 10 days. Her past history includes a diagnosis of lymphoma in the early 1980’s—a non-Hodgkin stage IIE variety with favorable histologic status. She underwent 4 cycles of CHOP therapy followed by radiation treatment. Lymphomatous involvement was initially found in her right salivary gland, right submandibular gland, and left inner cheek. Plain film radiographs and the illustrated MR examination of the patient’s right arm revealed an ill-defined mass involving right humeral metaphysis. [...]

Osteosarcoma

This 28-year-old man presented with increasing pain and swelling in his right shoulder for more than four months. Physical exam revealed an obvious swelling, with overlying normal skin, involving the right shoulder. Because of the swelling and pain, movement of the joint was restricted. [...]