Thanks to the development of new ultrasound machines,
easy access,
the innocuous character and low cost,
ultrasound for bone tumours may be a good choice in association to the rest of the imaging techniques.
In this context,
ultrasound can help in,
at least,
the following four areas.
- DISTINCTION BETWEEN SOLID AND LIQUID TUMOR CONTENT:
A liquid content of a tumour is easily identifiable with High resolution US coupled to Colour Doppler.
Cystic tumours as well as ganglion bone cysts,
can be diagnosed with a high level of confidence (Fig.
1,
2)
Possible differential diagnoses are abscesses and haematomas
- ASSESSMENT OF TUMORAL ECHOTEXTURE
When the content of a tumour is not fluid,
ultrasound can identify some typical echo-textures.
Internal septations or lobulations are easily seen as well as fluid-fluid levels.
Tumour vascular pattern as well can be analysed using Colour Doppler.
(Fig.
3,
4,
5,
6)
- CARTILAGINOUS TUMORS
Ultrasound is very useful when monitoring osteochondromas especially for identifying complications and detection of any degeneration (assessment of osteochondromas’ cartilaginous cap in appendicular skeleton) (Fig.
7,
8).
Local complications such as bursitis (Fig.
9,
10) or pseudo-aneurysms (Fig.
11) are easily diagnosed with US.
- MALIGNANT BONE TUMORS
The tumour,
as well as cortical interruption and periosteal bone formation may be seen on US.
(Fig.
12)
US is also useful in the assessment of the articular and vascular extension of the tumor.
A very privileged position is reserved for the ultrasound in monitoring postoperative bone tumours.
The use of metallic osteosynthesis material generates significant artefacts interfering with the interpretation of CT and MRI (Fig.
13).
In addition,
postoperative alterations of the operative site may generate doubtful images on MR and CT.
US is interesting for an early detection of post-operative tumour recurrence and/ or possible complications (Fig.
13,
14).