RESUMO
Appropriate imaging modalities for screening, staging, and surveillance of patients with suspected and documented metastatic disease to bone include (99m)Tc bone scanning, MRI, CT, radiography, and 2-[(18)F]fluoro-2-deoxyglucose-PET. Clinical scenarios reviewed include asymptomatic stage 1 breast carcinoma, symptomatic stage 2 breast carcinoma, abnormal bone scan results with breast carcinoma, pathologic fracture with known metastatic breast carcinoma, asymptomatic well-differentiated and poorly differentiated prostate carcinoma, vertebral fracture with history of malignancy, non-small-cell lung carcinoma staging, symptomatic multiple myeloma, osteosarcoma staging and surveillance, and suspected bone metastasis in a pregnant patient. No single imaging modality is consistently best for the assessment of metastatic bone disease across all tumor types and clinical situations. In some cases, no imaging is indicated. The recommendations contained herein are the result of evidence-based consensus by the ACR Appropriateness Criteria((R)) Expert Panel on Musculoskeletal Radiology.
Assuntos
Neoplasias Ósseas/diagnóstico , Neoplasias Ósseas/secundário , Diagnóstico por Imagem/normas , Guias de Prática Clínica como Assunto , Neoplasias da Mama/patologia , Medicina Baseada em Evidências/normas , Feminino , Humanos , Masculino , Estadiamento de Neoplasias , Gravidez , Complicações Neoplásicas na Gravidez/diagnóstico , Neoplasias da Próstata/patologia , Estados UnidosRESUMO
OBJECTIVE: The purpose of this study was to describe the technique of and experience in using CT guidance for percutaneous iliosacral screw placement in patients with unstable pelvic fractures. CONCLUSION: CT-guided iliosacral screw placement is a safe and accurate procedure that can be performed by radiologists in a radiology suite.
Assuntos
Parafusos Ósseos , Fixação Interna de Fraturas/instrumentação , Fraturas Ósseas/diagnóstico por imagem , Fraturas Ósseas/cirurgia , Ossos Pélvicos/lesões , Ossos Pélvicos/cirurgia , Cirurgia Assistida por Computador/métodos , Adolescente , Adulto , Idoso , Feminino , Fixação Interna de Fraturas/métodos , Humanos , Ílio/diagnóstico por imagem , Ílio/cirurgia , Instabilidade Articular/diagnóstico por imagem , Instabilidade Articular/cirurgia , Masculino , Pessoa de Meia-Idade , Ossos Pélvicos/diagnóstico por imagem , Implantação de Prótese/métodos , Sacro/diagnóstico por imagem , Sacro/cirurgia , Tomografia Computadorizada por Raios X/métodos , Resultado do TratamentoRESUMO
POEMS syndrome is a rare disorder in which patients present with the hallmark signs of polyneuropathy, organomegaly, endocrinopathy, M protein and skin changes. Many other clinical findings are also often present, most notably osseous lesions. The MRI appearance of the bony lesions in POEMS syndrome has been described in five cases, four of which are in the non-English literature. We report the MRI appearance of the osseous lesions in a patient with POEMS syndrome who presented with sciatic neuropathy.
Assuntos
Síndrome POEMS/diagnóstico , Adulto , Diagnóstico Diferencial , Humanos , Imageamento por Ressonância Magnética , Masculino , Síndrome POEMS/diagnóstico por imagem , Síndrome POEMS/terapia , Radiografia , Transplante de Células-TroncoRESUMO
There are relatively few reports of sacral stress fractures in children. In adolescents, sacral stress fractures have been reported in patients involved in vigorous athletic activity. Recognition of these fractures is important to avoid unnecessary biopsy if the findings are confused with tumor or infection. We report a sacral fatigue fracture in a 15-year-old without a history of athletic participation or trauma.
Assuntos
Fraturas de Estresse/diagnóstico , Sacro/lesões , Adolescente , Diagnóstico Diferencial , Feminino , Fraturas de Estresse/complicações , Humanos , Dor Lombar/etiologia , Imageamento por Ressonância Magnética , Sacro/diagnóstico por imagem , Tomografia Computadorizada de EmissãoRESUMO
Osteosarcoma of the mandible is a rare lesion. We report the case of a 16-year-old male who developed a fibroblastic osteosarcoma at the site of a wisdom tooth extraction. The lesion followed an aggressive course of recurrence and diffuse disseminated osteosarcomatosis. We speculate on the causal factors that resulted in this rapid course.