Imaging of the primary site is essential to make the diagnosis and to start to establish the extent of the primary lesion:
|
Plain Films |
Role |
First investigation to show abnormal-appearing bone
|
Appearance |
Lytic lesion of flat bone or diaphysis or metadiaphysis of tubular bone
|
Limitations |
The extent of spread through the medullary cavity and adjacent soft tissues is usually greater than indicated on plain radiographs
|
The plain film below is of a primary ES involving the femoral diaphysis. There is an aggressive periosteal reaction (A points to this area).
A Codman triangle is sometimes seen with aggressive bone tumors such as ES.
The chest X-ray below shows a large right sided ES (#1) arising from a rib.
