Lytic bone lesion

Lytic lesion, location
Well defined - Narrow zone of transition = benign
Diaphyseal Medulla With or without sclerotic margin
Enchondroma - Hands and feet, May have GG appearance, May have calcification, mildly expansile, endosteal scalloping
EG - Can have sclerotic margin during healing, Sclerotic margin
SBC -
FD

- No sclerotic margin
Mets, plasmacytoma, lymphoma
Illdefined – wide zone of transition = malignant
Mets – may have narrow zone of transition
Myeloma – rain drops, multiple
Lymphoma
OS – periosteal reaction, osteoid matrix
Ewings – periosteal reaction, age
CS – cartilage matrix
MFH – non specific
Osteomyelitis – sequestraion, involucrum

Metaphyseal
ABC
Unfused epiphysis, expansile
NOF
Eccentric, medullary
FCD
Eccentric, cortical
CMF
May extend into epiphysis
May have sclerotic margins

Metaepiphyseal
GCT
Eccentric, expansile

Epiphpyseal
Brodie’s
CB
Epiphyseal
Can have calcification
Subarticular
OA/ CPPD/ arthritidis subarticular cysts
Gout
PVNS
Hemophilia
Mets, myeloma, lymphoma
GCT
CB
Post traumatic
TB

Grossly expansile

Mets
RCC
Thyroid
Melanoma
Also bronchus, breast, pheochromocytoma
Myeloma/ plasmacytoma
Lymphoma

CS
OS – telangiectactic

ABC
GCT
Enchondroma
FD

Hemophilic pseudotumor
Brown tumor

Calcium containing lytic lesions

Cartilage tumors
EC
CB
CMF
Bone tumors
OO
OB
OS
FD
Paget’s
OM sequestration
Introsseous lipoma





Moth eaten appearance

Mets
Myeloma
Lymphoma
Leukemia
Ewings
OS
CS
His X