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Erosive bone destruction

Introduction
Cause
Examine
Diagnosis

Introduction

Introduction Erosive bone destruction means that the malignant bone tumor has no exact boundary of destruction, and there is no hardened ring, and the tumor and the normal bone gradually migrate.

Cause

Cause

Aggressive bone destruction is caused by malignant bone tumors and is also seen in bone infections.

Examine

an examination

Related inspection

Bone three-phase imaging X-ray iodine oil angiography bone and joint MRI examination

Main X-ray signs of malignant bone tumors:

(1) Bone destruction: Malignant bone tumors are infiltrated in the cortex or the marrow, and the boundary between the lesion and the normal tissue is blurred and the edges are irregular. The destruction of the cortical bone by the x-ray film is easier to find than the intramedullary bone destruction.

(2) Bone destruction boundary: Malignant bone tumor has no exact boundary of destruction, no hardened ring, and gradually migrates between tumor and normal bone. The characteristics of this type of aggressive bone destruction are also seen in bone infections.

(3) periosteal reaction: most malignant bone tumors have different types of periosteal reactions, such as onion skin, comb, multi-layer, etc., especially attention to the rapid development of malignant bone tumors, periosteal reaction is often broken by tumors, X-ray findings The periosteal reaction was disrupted, interrupted, and incomplete, and a soft tissue mass appeared in the interrupted periosteal reaction, Codman triangle.

(4) soft tissue mass: malignant bone tumor grows rapidly, the cortex is easily broken into the soft tissue to infiltrate, forming a soft tissue mass shadow, and the boundary with the surrounding is unclear.

Diagnosis

Differential diagnosis

Differential diagnosis of benign and malignant tumors

X-ray plain film diagnosis of bone tumors should focus on distinguishing the different manifestations of benign and malignant bone tumors after identifying non-neoplastic diseases. Although the benign and malignant tumors of different tissue sources are complex and diverse, there are a series of common manifestations between benign tumors and malignant tumors. There are many differences in image changes between benign and malignant bone tumors. Understanding and analyzing them The difference between them will be of great help for further diagnosis of individual tumors and for different clinical treatments.

1. Benign bone tumors: the boundary contour is clear, and most of them are cystic or cystic dilatation changes. There are or no hardening new bone surrounding the damaged area, and there is a large amount of reaction when there is a hyperplasia. Osteophytes appear, generally no periosteal reaction or only a slight periosteal hyperplasia, generally no soft tissue mass.

2. Malignant bone tumor: The bone destruction is infiltrated with patchy, worm-like, and sieve-like. There is no clear boundary in the spread, and there are many forms of periosteal reaction such as comb, radial, lace, etc. The cortical bone is broken through early soft tissue mass.