The purpose of this articleis to systematically describe and illustrate important clues for differentiating the diagnosis of sclerotic bone lesions.
Bone sclerosis is “an abnormal increase in density and hardening of bone” according to Biology online.
In our clinical practice,
sclerotic bone lesions are relatively common on plain radiographs or CT scans.
differential diagnosis of the sclerotic bone lesions is often challenging for radiologists.
Because of the treatment options vary,
it may be useful to be able to differentiate these lesions by imaging criteria.
For systematic approach,
several steps are needed.
Imaging findings OR Procedure details
First step; Number and pattern of lesion
The sclerotic lesions can be classified into solitary,
and diffuse types according to the number and extent of the lesion.
The ‘multifocal’ means multiple lesions with relatively discrete border and the ‘diffuse’ means lesions with indistinct border and large extent involving one or more anatomic site.
Second step; Degree of homogeneity of solitary lesion
Heterogeneous density demonstrates mixed pattern of osteoblastic and osteolytic portions.
Third step; Location of solitary lesion
The focal lesion can...
Sclerotic bone lesions show various morphologies from definitely pathognomonic findings to non-specific findings.
they have various disease entities.
This systematic approach using flow chart and the familiarity with the imaging features of various sclerotic bone lesions may be helpful for narrowing the differential diagnosis.
1. Meyers SP.
MRI of bone and soft tissue tumors and tumorlike lesions.
Newyork: Thieme; 2008.
2. Propeck T,
Radiologic-pathologic correlation of intraosseous lipomas.
AJR Am J Roentgenol.
3. Cerase A,
Skeletal benign bone-forming lesions.
Eur J Radiol 1998;27 Suppl 1:S91-97.
4. Levine SM,
Cortical lesions of the tibia: characteristic appearances at conventional radiography.
5. Murphey MD,
Imaging of osteochondroma: variants and complications with...