Bone destruction

Introduction Bone destruction refers to the loss of bone tissue caused by local bone replacement by pathological tissue. In imaging, there is a localized reduction in bone density, sparse or blurred trabecular bone, osteocortical or mesh-like, partial bone defect or structural disappearance. Clinically common in bone inflammation, granuloma, tumor or tumor-like lesions. The bone destruction of different causes is different. Generally, the bone damage of acute inflammation or malignant tumor is rapid, and the boundary is irregular or blurred. The bone destruction of chronic inflammation or benign tumors progresses slowly and the boundaries are clear. The bone destruction methods are summarized into four types: osteolytic type, broken bone type, subperiosteal type and localized osteolytic edge hardening type. Osteolytic destruction is most common.

Cause

It is caused by the pathological tissue itself directly dissolving and absorbing bone tissue, or by osteoclastogenesis and hyperactivity caused by pathological tissues. Both cortical bone and cancellous bone can be destroyed. Clinically common in bone inflammation, granuloma, tumor or tumor-like lesions.

an examination

Related inspection

Bone alkaline phosphatase bone and joint soft tissue CT examination of serum viscosity

CT manifestations of osteolytic destruction: There are single or multiple osteolysis in the vertebral body, which is round or round-shaped low-density area, and some are cave-like, honeycomb-like, with no hardened edges. The bone piece is typically expressed as a "seed egg-like"; it can penetrate the cortical bone to the periphery.

CT findings of fragmental bone destruction: the vertebral body collapses and loses its integrity into multiple bone fragments. The size and shape are different and the density is different. The broken bone fragments can invade the spinal epidural space and paravertebral tissue. Or found in the vertebral attachment and rib destruction zone.

CT findings of subperiosteal destruction: the anterior edge of the vertebral body is worm-like or rat-like bone destruction, and the adjacent vertebral body can be involved up and down the subperiosteal and anterior longitudinal ligament. Paravertebral abscess is often more obvious.

CT manifestations of osteolytic marginal sclerosis: manifested as localized osteolytic destruction in the first half of the vertebrae, irregular shape, more obvious hardening margin, no dead bones, no obvious paravertebral abscess or only a slight swelling of the paravertebral soft tissue.

Differential diagnosis

diagnosis

Diagnosis is based on symptom performance.

Differential diagnosis

1. Osteonecrosis: It is the stoppage of local metabolism of bone tissue. The necrotic bone is called sequestrum. The main reason is the interruption of blood supply, more common in suppurative osteomyelitis, bone tuberculosis, bone ischemic necrosis and traumatic fractures, or residual bone in some malignant bone tumors. X-ray showed an increase in bone localized density.

2, osteoporosis: Osteoporosis (osteoporosis) is a group of bone diseases caused by a variety of reasons. The bone tissue has normal calcification, and the calcium salt and the matrix are in a normal ratio, and the amount of bone tissue per unit volume is reduced to a special metabolic bone lesion. In most osteoporosis, the reduction in bone tissue is mainly due to increased bone resorption. The incidence is slow, individual is faster, characterized by bone pain and easy fracture. The biochemical examination is basically normal. Pathological anatomy showed that the cortical bone was thin, the trabecular bone was sparsely atrophied, and the bone-like layer was not thick.

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