Osteoporosis

Radiology Osteoporosis
I Metastases
Radiology Osteoporosis

Fig. 8.25 This is a radiograph of the thoracolumbar spine. The first lumbar vertebra is recognized by the fact that no ribs originate from it. First analyze all the dorsal spinous processes on this film. Are all of them present? Now go ahead and follow the upper and lower end plates as well as the lateral contours of all the bodies. Are they complete? Finally check out the pedicles. The T11 pedicle on the right is gone, the pedicle of T12 is denser that the others. The T11 abnormality is most likely due to an osteolytic metastasis. The T12 lesion could be an osteoblastic metastasis. The patient had a breast carcinoma.

Fig. 8.25 This is a radiograph of the thoracolumbar spine. The first lumbar vertebra is recognized by the fact that no ribs originate from it. First analyze all the dorsal spinous processes on this film. Are all of them present? Now go ahead and follow the upper and lower end plates as well as the lateral contours of all the bodies. Are they complete? Finally check out the pedicles. The T11 pedicle on the right is gone, the pedicle of T12 is denser that the others. The T11 abnormality is most likely due to an osteolytic metastasis. The T12 lesion could be an osteoblastic metastasis. The patient had a breast carcinoma.

f Try to see in your mind's eye a three-dimensional model of i the vertebral body you analyse on the radiograph. Only now can you determine whether it is complete or partially destroyed. Especially with air and intestinal content overlying the bone, large osteolytic lesions may be overlooked or overstated. The correlation with the bone scan (exception: myeloma) is therefore helpful in many cases. If doubts persist and if therapy depends on the outcome, CT and MR are the next steps.

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