Oncology Research Today is a free monthly online journal that collates and summarizes the latest research about Oncology, including details on cancer, surgery, chemotherapy, radiotherapy.

Pitfalls in MR image interpretation prompting referrals to an orthopedic oncology clinic.

Stacy GS, Dixon LB

Department of Radiology, University of Chicago Hospitals, 5841 S Maryland Ave, MC 2026, Chicago, IL 60637, USA. sstacy@radiology.bsd.uchicago.edu

Patients referred to the authors' hospital for evaluation on suspicion of a bone or soft-tissue malignancy frequently present to the Orthopaedic Oncology Clinic with magnetic resonance (MR) images that show typical features of nonmalignant or nonneoplastic entities. The purpose of this article is to review the benign entities that may be mistaken by the radiologist for a malignancy and thus lead to needless referral to an orthopedic oncologist. Normal hematopoietic marrow and marrow edema due to a stress reaction may mimic a neoplasm at MR imaging, but knowledge of the typical patterns and locations of these features allows an accurate radiologic interpretation. The MR imaging appearance of osteonecrosis, Paget disease, benign bone lesions, and rheumatologic conditions may be confusing; in such circumstances, radiographic findings may help formulate a correct diagnosis. Knowledge of the common locations and appearances of bursae and ganglia is necessary so that radiologists do not misinterpret these benign entities as soft-tissue sarcomas. Soft-tissue trauma and inflammation also may mimic tumors at MR imaging, but a familiarity with the imaging patterns of nonneoplastic change in muscle allows the avoidance of misinterpretation. The clinical history, as always, is an important component of proper diagnosis. The radiologist can be especially useful to both the clinician and the patient by recognizing entities that are highly unlikely to represent malignancy and by confidently reporting those entities as benign, thereby sparing the patient an unnecessary trip to the orthopedic oncologist.

Published 14 May 2007 in Radiographics, 27(3): 805-26; discussion 827-8.
Full-text of this article is available online (may require subscription).

© 2005-2008 Oncology Research Today. All Rights Reserved.