Multiple Myeloma is a neoplasm of differentiated plasma cells resulting from malignant clonal expansion and overproduction of monoclonal immunoglobulins. Common complications include recurrent bacterial infections, anemia, osteolytic lesions and renal insufficiency. Diagnostic Radiology/Musculoskeletal Imaging/Tumors Basic/Multiple Myeloma From Wikibooks, the open-content textbooks collection

Radiology case 48--1611

Definition Neurofibromatosis type I (NF-1), along with Neurofibromatosis type II (a.k.a. MISME syndrome), Tuberous Sclerosis, Sturge-Weber, and Von Hippel-Lindau compromise the phakomatosis or neurocutaneous syndromes, all of which have neurologic and dermatologic lesions. This grouping is an artifact of an earlier time in medicine, before the distinct genetic basis of each of these diseases was understood. Etiology Neurofibromatosis type I (NF-1), also known as von Recklinghausen disease, is the result of a defect on Chromosome 17. from Diagnostic Radiology/Musculoskeletal Imaging/Dysplasia Basic/Neurofibromatosis From Wikibooks, the open-content textbooks collection

Bilateral, symmetric sclerosis of the iliac side of the sacro-iliac joint is present in this young female, who presents with an unrelated history (motor vehicle accident). The sclerosis appears triangular with the base located inferiorly. Erosions are absent. some facts concerning Osteitis Condensans Ilii: Symmetric sclerosis of the iliac side of the sacro-iliac joint found in young multiparous women. Can be seen in males. Felt to be a stress related phenomenon secondary to instability at the symphysis pubis. May be painful. May spontaneously resolve on cessation of stress or on surgical stabilization at the symphysis pubis.

Radiology case 451-442
Clinical presentation: 13 year old male with pain in the knees. There are almost symmetrical defects of the articular surfaces on the medial side of the lateral condyles of both femora. On the left side the separated bone remains close to its site of origin. In the right knee, the fragment has moved and may be responsible for the ill-defined intra-articular densities, projected between the lateral conyles of right femur and tibia. The endosteal margin is better defined on the right side and this may reflect its greater exposure to intra-articular pressure changes or the density may be due to creeping substitution of newbone over old.

Osteochondromas are cartilage-covered, histologically normal bony projections (exostoses) on the external surface of a bone in the vicinity of growth plates. They are the most common benign bone lesions and present during late childhood and adolescence. Although any bone with enchondral ossification may be involved, the femur, the proximal tibia, and the proximal humerus account for approximately 65-85% of cases. There is a hereditary skeletal dysplasia known as osteochondromatosis (multiple heritable exostoses) where multiple exostoses are distributed symetrically on the skeleton. This is a autosomal-dominant disease and is one of the most common skeletal dysplasias. The condition is familial, with more severe manifestations in men. Diagnostic Radiology/Musculoskeletal Imaging/Tumors Basic/Osteochondroma From Wikibooks, the open-content textbooks collection

osteochondrosis (aka osteochondritis) dissecans

Radiology Lecture with good illustrations; Includes - Osteochondroses, Scheuermann's, Legg Calve Perthes, Spontaneous Osteonecrosis of the knee, gout, hemochromatosis, chondrocalcinosis, hyperparathyroidism, metastatic disease, osteochondritis dissecans, osteoporosis, osteogenesis imperfecta & renal osteodystrophy

Osteoid osteoma is a benign osteoblastic (bone forming) tumor. It consists of a highly vascularized osteoid core. The growing core induces a peripheral zone of sclerosis and periosteal reaction. Diagnostic Radiology/Musculoskeletal Imaging/Tumors Basic/Osteoid ostemoa From Wikibooks, the open-content textbooks collection

Osteosarcoma is the most common malignant primary bone tumor. Osteosarcoma tends to occur in children and young adults typically 10-25 or 30 years of age. Osteosarcomas also tend to occur in patients in the sixth decade, likely related to malignant degeneration of Paget's disease. It is said that they tend to occur most often towards the end of long bones in the metaphyseal region but they can also arise in the diaphysis and there is enough variation that this parameter is not terribly helpful in differentiation. A typical osteosarcoma is destructive with associated sclerosis from either malignant bone formation or reactive sclerosis. There are multiple types of osteosarcoma. The most common of which is the Conventional Osteosarcoma which accounts for 75% of cases. Conventional osteosarcoma is typically located around the knee and is a very aggressive lesion associated with a soft tissue mass, cortical destruction, a permeative pattern of bone change. Most demonstrate some degree of osteoid matrix. Conventional osteosarcomas commonly arise in the metadiaphysis but regularly (75%) cross the physis to involve the epiphysis. The distal femur and proximal tibia are the bones most commonly involved, followed by the humerus and iliac wing. They have a rapid doubling rate, are often large when discovered and are aggressive in appearance. Lesions are typically permeative with a wide zone of transition. Cortical breakthrough can be seen typically with a large soft tissue mass. Periosteal reaction typically presents with a Codman’s triangle or sunburst pattern. At least 90% of conventional osteosarcomas produce osteoid matrix in variable quantities which alters their radiographic appearance. Lesions that are dense appear low in signal on T1 and T2 sequences and if they are less dense, typically will be low signal on T1 and higher signal on T2 imaging. Diagnostic Radiology/Musculoskeletal Imaging/Tumors Basic/Osteosarcoma From Wikibooks, the open-content textbooks collection

Pagets disease disease of unknown etiology involving destruction and reparation

Clinical presentation: 80 year old lady with pain in her right hip. There is increased density of the right hemi-pelvis. The bone dimensions are increased. There is coarsening of the bone architecture with loss of detail. There is protrusio acetabulae, indicating bone softening. ACR-code 448-843

Radiology case 438-843: Pagets Disease