Rad Dx


Lesion Descriptors
Number:	solitary multiple (2-5) multiple (>5)
Location (bone):	skull jaw orbit cervical spine dorsal spine lumbar spine sacrum & pelvis femur fibula tibia tarsal / carpal bones (1-5) metatarsal / metacarpal bones phalanges (proximal, middle, distal) ribs sternum clavicle scapula humerus radius ulna other
Location (joint):	1st IP (hand) 2nd-5th PIP (hand) 2nd-5th DIP 1st MCP (hand) 2nd-5th MCP (hand) 1st CMP (hand) 2nd-5th CMP (hand) midcarpal / intercarpal (wrist) radiocarpal (wrist) distal (inferior) radioulnar (wrist) proximal (sup) radioulnar / radiohumeral / humero-ulnar (elbow) glenohumeral joint (shoulder) acromioclavicular (shoulder) sternoclavicular temporomandibular (jaw) C1-C2 (spine) facet joints (spine) SI (pelvis) symphisis pubis (pelvis) acetabulofemoral (hip) femurotibial (medial) (knee) femurotibial (lateral) (knee) femuropatellar (knee) proximal (superior) tibiofibular (knee) distal (inferior) tibiofibular - talus (ankle) talocalcaneal(ankle) talocalcaneal-tarsal (ankle) intertarsal (foot) 1st MTP (foot) 2nd-5th MTP (foot) 1st IP (toe) (foot) 2nd-5th PIP (foot) 2nd-5th DIP (foot)
Location (other):	soft tissue subcutaneus fascia muscles
Distribution / Topography:	bilateral unilateral symmetrical asymmetrical medial lateral anterior posterior long bone - epiphysis long bone - metaphysis (long) long bone - diaphysis (long) bone- proximal third bone - middle third bone - distal third central eccentric periosteal / juxtacortical anterior column (vertebra) middle column (vertebra) posterior column (vertebra)

Plain film & CT Findings

Plain Film & CT:

geographic or well-defined
permeative or moth-eaten
lytic/lucent
sclerotic
mixed
calcifications/predominantely calcified
calcified intra-articular loose bodies / bone debris
periarticular / subcutaneus calcifications
chondrocalcinosis
phleboliths
fragmentation and osseous debris
matrix: osteoid - ivory, fluffy, cloud-like
matrix: chondroid - arcs, rings, punctuate, stippled
matrix: fibrous - ground glass, hazy
zone of transition: wide
zone of transition: narrow
zone of transition: non-sclerotic
zone of transition: sclerotic
periosteal reaction: absent
periosteal reaction: solid
periosteal reaction: onion skin = lamelated
periosteal reaction: sunburst/hair on end
periosteal reaction: codman triangle
periosteal reaction: solitary/localized (unilateral)
periosteal reaction: bilateral symmetrical
periosteal reaction: bilateral asymmetrical
bone density: generalized increased
bone density: subchondral sclerosis
bone density: periarticular osteopenia
bone density: diffuse osteopenia
coarse trabecular pattern
thickening of the cortical bone
osteophytes/syndesmophytes
ankylosis
joint space: preserved
joint space: widened
joint space: narrowed (non-uniform)
joint space: narrowed uniform
vacuum phenomenon
geodes
subluxations / deformities
absent erosions
ill-defined erosions
well-defined erosions
marginal erosions
central erosions

MRI Findings

MR signal:

T1 hyperintense
T1 hypointense (lower than muscle)
T2 hyperintense-intermediate
T2 hyperintense (cyst-like)
T2 hypointense
hyperedematous (surrounding marrow edema signal >> lesion)
susceptibility artifact - hemosiderin
flow void

Enhancement Pattern

Enhancement:

no enhancement
faint
heterogeneous - partly cystic or necrotic
heterogeneous - nodular
thin rim (cyst like)
thick rim (abscess like)
diffuse - moderate
diffuse - strong

Miscellaneous Findings

Miscellaneous:

endosteal scalloping
fluid-levels
cystic degeneration
skip lesions
expansile/aneurysmal
spinal canal extension
soft tissue swelling
tophi / soft-tissue nodules
erosion of the distal tuft / distal phalangeal destruction
bone "squaring"
overgrown or ballon epiphyses
premature fusion / decreased bone length
cortical disruption / pathologic fracture

Fracture Analysis

Fracture:

open
closed
angulation: varus
angulation: valgus
angulation: dorsal
angulation: volar/plantar
fragment overlap
rotation
cominution: 1-3
cominution: >3
complete: transverse
complete: oblique
complete: spiral
incomplete
impaction
compression
avulsion Pattern
stress Pattern
dislocation
subluxation


Patient Data
Clinic:	acute chronic pain painless fever leukocytosis renal osteodystrophy
History:	trauma arhritis known malignancy prior surgery (on the same site) / pre-existing lesion
Age:	years old

Differential Diagnoses in Radiology

MSK