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Home > Disclaimer > Osteosarcoma

Primary bone

 

Plain films are the gold standard for the diagnosis of all bone tumours

Site	Metaphysis of a Long Bone
Appearance	Destructive
Margin/Border	Poorly defined Permeative
Periosteum	Extensively disrupted due to the growing soft tissue mass New bone laid down in a disorderly fashion resulting in characteristic “hair-on-end” and “sunburst” appearances New bone at the edge of the lesion results in a Codmans Triangle All of these are signs of an aggressively growing tumour
Matrix	Osteoid produced by tumour cells appears as radiodense areas
Soft Tissue Mass	Can often be seen on a good quality X-ray

Plain films need to be interpreted by a musculoskeletal radiologist or subspecialty orthopaedic surgeon with  experience in the radiology of bone tumours.

The plain film below is of a large osteogenic sarcoma with an aggressive periosteal reaction (#1 shows a Codman's triangle - where the periosteum starts to lift off the bone).  There is both bony destruction and new bone formation (#2) centred on the distal femoral meta-diaphysis.

 

A second opinion should be sought on all patients with suspicious bone lesions on X-ray

 

 

Chest X-ray

Shows metastatic disease.

All patients should have a baseline Chest XRay for future reference.

The radiograph below shows multiple, bilateral pulmonary metastases associated with osteogenic sarcoma.

 

 

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