E1917. Double, Bubble, Biopsy, and Trouble: The Proper Potion for Your Benign Lucent Bone Lesion Differential Diagnosis
  1. Jane Ball; LSUHSC New Orleans
  2. Mark Froom; LSUHSC New Orleans
Benign lucent bone lesions are commonly encountered in daily radiology practice. Clinicians appreciate radiologists who provide a concise and helpful differential diagnosis for a given lesion. Appropriate follow-up recommendations protect the patient from unnecessary imaging and procedures such as biopsies. In order to make those appropriate recommendations, the radiologist must be able to deftly rule in and rule out diagnoses based on the imaging findings, patient age, and patient clinical history. Review of this exhibit teaches the salient imaging findings and associations to build strong differential diagnoses. Further, new and well-known mnemonics are offered to facilitate memorization of the diagnoses.

Educational Goals / Teaching Points
This exhibit will prepare the radiology trainee to confidently narrow their differential diagnosis for benign lucent bone lesions in order to prevent unnecessary follow-up imaging and biopsies. The cases provided will focus on pattern recognition, clinical history, and pertinent findings to reliably distinguish between similar-appearing lesions. Additionally, imaging appearance between modalities will be compared, including radiographs, computed tomography, and magnetic resonance imaging.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Often benign lucent bone lesions can be reliably diagnosed based on plain radiographs and the patient’s age and clinical history. Sometimes other imaging modalities are utilized to evaluate the patient for the lesion or for another complaint, so characteristic features of benign lucent lesions on computed tomography and magnetic resonance imaging are important to know as well. With reliable imaging diagnoses and differentials, the biopsy of benign lucent bone lesions can be avoided due to lack of utility and the small but real risk of complications for the patient.

Regular review of differentials and appropriate recommendations for benign lucent bone lesions will serve the radiologist trainee throughout their career and ensures they are helpful to the referring clinicians. Findings on radiographs, computed tomography, and magnetic resonance imaging may overlap between benign lesions and between benign and malignant lesions, so careful consideration of all factors is important for forming strong diagnoses and differential diagnoses.