E1582. Daily Pseudo-Lesions in Adult Musculoskeletal Plain Radiographs
Authors
Hyo Jin Kim;
SMG-SNU Boramae Medical Center
Background
In this educational review, the author describes commonly encountered pseudo-lesions in adult musculoskeletal plain radiographs with some differential diagnosis tips from true lesions.
Educational Goals / Teaching Points
Reduce unnecessary confusion in daily practice of novice radiologists.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
After reviewing the literature on normal radiographic findings simulating disease, the author listed a number of fake lesions commonly encountered in everyday practice and categorized them into ‘pseudo-traumatic’, ‘pseudo-neoplasm’, and ‘pseudo-inflammation’. Then images belonging to each category were introduced with explanations. In some cases, examples of true lesions mimicked by pseudo-lesions were also attached with differential diagnosis tips. Pseudo-traumatic (pseudo-notch of atlas, odontoid process pseudo-fracture, odontoid process developmental cleft, pseudo-subluxation of the cervical spine, backward displacement of C2, notochordal remnant, clavicle canal, and pseudo-subluxation of acromioclavicular joint). Pseudo-neoplasm (odontoid ring, greater tuberosity lucency, radial tuberosity lucency, speckled pattern of the femur trabeculae, tug lesionst, tibia tuberosity lucency, pseudo-cyst of the calcaneus, and pseudo-cyst of the first toe). Pseudo-inflammation (joint vacuum, acetabular notch, capitate fossa, fifth metacarpal fossa, pit-like depression in the metacarpal and metatarsal head, notch of the phalanx base, and tuft sclerosis).
Conclusion
The knowledge of common radiographic musculoskeletal pseudo-lesions will help novice radiologists to distinguish insignificant findings from true lesions requiring additional advanced imaging or treatment.
