Plain Radiologic Findings and Chronological Changes of Incipient Phase Osteosarcoma Overlooked by Primary Physicians.
10.4055/cios.2014.6.2.230
- Author:
Won Seok SONG
1
;
Dae Geun JEON
;
Wan Hyeong CHO
;
Chang Bae KONG
;
Sang Hyun CHO
;
Jung Wook LEE
;
Soo Yong LEE
Author Information
1. Department of Orthopedic Surgery, Korea Cancer Center Hospital, Seoul, Korea. dgjeon@kcch.re.kr
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Osteosarcoma;
Incipient phase;
Plain radiographic findings;
Chronological changes
- MeSH:
Adolescent;
Adult;
Age Factors;
Bone Neoplasms/diagnosis/*radiography;
*Diagnostic Errors;
Female;
Humans;
Magnetic Resonance Imaging;
Male;
Osteosarcoma/diagnosis/*radiography;
Retrospective Studies;
Young Adult
- From:Clinics in Orthopedic Surgery
2014;6(2):230-235
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: We assessed the plain radiographic characteristics of 10 cases of osteosarcomas during the initial painful period that had been overlooked by a primary physician. In addition, we evaluated chronologic changes in radiographic findings from initial symptomatic period to the time of accurate diagnosis. METHODS: The clinical records were reviewed for clinical parameters including age, sex, location, presenting symptoms, initial diagnosis, duration from initial symptoms to definite diagnosis, and initial and follow-up plain radiographic findings of the lesion. RESULTS: Initial clinical diagnoses included a sprain in 6, growing pain in 2, stress fracture in 1, and infection in 1 patient. Initial plain radiographic findings were trabecular destruction (100%), cortical disruption (60%), periosteal reaction (60%), and soft tissue mass (10%). Intramedullary matrix changes were osteosclerosis in 6 and osteolysis in 4 patients. On progression, 4 cases with minimal sclerosis changed to osteoblastic lesion in 3 patients and osteolytic lesion in 1. Four cases with faint osteolytic foci transformed into osteolytic lesion in 3 and mixed pattern in 1. CONCLUSIONS: Notable plain radiologic findings of incipient-stage osteosarcoma include trabecular disruption along with faint osteosclerosis or osteolysis. In symptomatic patients with trabecular destruction, additional imaging study including magnetic resonance imaging should be performed to exclude osteosarcoma in the incipient phase, even without radiologic findings suggesting malignant tumor, such as cortical destruction or periosteal reaction.
