EURORAD ESR

Case 14564

An unusual cause of bone lesions in paediatric age

Author(s)
Costa, R1; Oliveira, C1; Dionísio, A1; Coelho, P2; Caseiro-Alves F1.

(1) Medical Imaging Department
(2) Coimbra Pediatric Hospital

Coimbra Hospital and University Centre,
Coimbra, Portugal.
 
Patient
female, 14 year(s)
 
 
  • Figure 1
    Anteroposterior and lateral radiographs of the right femur

    Frontal (a) and lateral (b) radiographs show lytic permeative changes in the distal metadiaphysis of the right femur with a lamellated periosteal reaction (arrows).

     
    Area of Interest: Haematologic; Musculoskeletal bone; Paediatric; Imaging Technique: Plain radiographic studies; Procedure: Diagnostic procedure; Special Focus: Lymphoma; Neoplasia;
     
     
  • Figure 2
    MR Imaging. Axial (a) and coronal (b) T1-weighted images

    Multiple areas of bone marrow replacement in the distal femoral metadiaphysis (low signal areas), with physeal extension (asterisk). Cortical circumferencial thickening and lamellated periosteal reaction (arrows) is...

     
    Area of Interest: Haematologic; Musculoskeletal bone; Paediatric; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Haematologic diseases; Lymphoma;
     
     
  • Figure 3
    MR Imaging. Sagittal T2-W; FS T2-W (axial; sagittal)

    Multiple areas low/intermediate signal in the distal femoral metadiaphysis. Cortical circumferencial thickening and lamellated periosteal reaction is also evident (arrows). Note the peri-tumoral oedema (stars)...

     
    Area of Interest: Haematologic; Musculoskeletal bone; Paediatric; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Haematologic diseases; Lymphoma;
     
     
  • Figure 4
    MR Imaging. Coronal FS T1-W

    Fat-suppressed T1 weighted images before (a) and after (b) administration of contrast material shows areas of enhancement within the intramedullary lesion, without evidence of soft-tissue mass.

     
    Area of Interest: Haematologic; Musculoskeletal bone; Paediatric; Imaging Technique: MR; Procedure: Contrast agent-intravenous; Diagnostic procedure; Special Focus: Haematologic diseases; Lymphoma;
     
     
Frontal (a) and lateral (b) radiographs show lytic permeative changes in the distal metadiaphysis of the right femur with a lamellated periosteal reaction (arrows).
 
Multiple areas of bone marrow replacement in the distal femoral metadiaphysis (low signal areas), with physeal extension (asterisk). Cortical circumferencial thickening and lamellated periosteal reaction (arrows) is also present.
 
Multiple areas low/intermediate signal in the distal femoral metadiaphysis. Cortical circumferencial thickening and lamellated periosteal reaction is also evident (arrows). Note the peri-tumoral oedema (stars) without evidence of soft-tissue mass.
 
Fat-suppressed T1 weighted images before (a) and after (b) administration of contrast material shows areas of enhancement within the intramedullary lesion, without evidence of soft-tissue mass.
 
 
 
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