E5234. Demystifying Bone Lesions on Plain Film: An Illustrative Guide
  1. Aakash Babaria; Mather Hospital - Northwell Health
  2. Samuel Beaujean; Mather Hospital - Northwell Health
  3. Lisa Park; Mather Hospital - Northwell Health
Given the variety and overlapping features of bone lesions on plain films, one can easily get confused between common lesions. Although CT and MRI can help diagnose many lesions more accurately, x-ray is the primary imaging modality used to diagnose and differentiate them. This exhibit aims to provide an organized approach to accurately diagnose bone lesions, including benign and malignant tumors.

Educational Goals / Teaching Points
Provide an organized approach to differentiating bone lesions on x-ray based on imaging characteristics, lesion location, and patient age. Illustrations and labeled case images of each type of lesion are provided to facilitate learning.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
X-ray is primarily used to differentiate many osseus lesions. This educational exhibit provides a breakdown of common epiphyseal, metaphyseal, and diaphyseal lesions. Epiphyseal lesions include chondroblastoma, clear cell chondrosarcoma, giant cell tumor, geode, and intraosseous ganglion. Metaphyseal lesions include osteosarcoma, chondrosarcoma, nonossifying fibroma, solitary bone cyst, and chondromyxoid fibroma. Diaphyseal lesions include simple bone cyst, fibrous dysplasia, Ewing’s sarcoma, osteoid osteoma, enchondroma, and osteoblastoma. A detail-oriented approach with unique imaging features, typical age range, and lesion growth patterns allows the learner to improve their understanding.

There is a wide variety of bone lesions, ranging from simple bone cysts to malignant neoplasms, that can be effectively differentiated on x-ray. Learning the unique characteristics of each lesion type allows the radiologist to improve diagnostic accuracy.