3 Osteosclerotic Vertebral Lesions

CLINICAL IMAGAGINGAN ATLAS OF DIFFERENTIAL DAIGNOSIS

EISENBERG

DR. Muhammad Bin Zulfiqar PGR-FCPS III SIMS/SHL

Fig SP 3-1 Osteoblastic metastases (ivory vertebrae). (A) Carcinoma of the prostate. (B) Lymphoma.

• Fig SP 3-2 Paget's disease. Sclerotic vertebral body with associated enlargement and cortical thickening.4

• Fig SP 3-3 Chronic osteomyelitis. There is destruction and collapse of bone with reactive sclerosis and narrowing of two intervertebral disk spaces. Note the poorly defined or fuzzy diskovertebral junctions associated with this pyogenic infection.2

• Fig SP 3-4 Osteoid osteoma. (A) Sclerotic lesion of a pedicle (arrowhead). (B) Radiolucent nidus (arrowhead) in an inferior articular process. (C) Axial CT scan clearly shows the radiolucent nidus (arrowhead) in a transverse process.2

• Fig SP 3-5 Mastocytosis. (A) Frontal and (B) lateral radiographs of the thoracic region of the spine show focal osteosclerotic lesions associated with paravertebral swelling.2

• Fig SP 3-6 Osteopoikilosis. Multiple sclerotic foci in the margins of the vertebral bodies and posterior elements.2

• Fig SP 3-7 Melorheostosis. (A, B, and C) Three radiographs of the axial skeleton show hyperostosis and enostoses involving the upper right ribs, the thoracic and lumbar vertebrae, the sacrum, and the ilium. Quadriparesis developed in this 21-year-old man because of a diffuse intramedullary lipoma in the spinal cord.2

• Fig SP 3-8 Congenital stippled epiphyses. Multiple, small punctate calcifications of various sizes involve virtually all the epiphyses in this view of the chest and upper abdomen.

• Fig SP 3-9 Tuberous sclerosis. Left oblique view shows a homogeneously dense left pedicle and superior articular facet (arrow). This was an incidental finding on excretory urography.2