Bismillah

Basic Sciences
PERAN FOTO POLOS
PADA
TUMOR MUSKULOSKELETAL
Edy Moeljono, Anita Ekowati, Evi Artsini

Bagian Radiologi FK UGM/RS Dr. Sardjito

Yogyakarta
Bismillah

Basic Sciences
THE ROLE OF PLAIN PHOTO
in
MUSCULOSKELETAL TUMOR
Edy Moeljono, Anita Ekowati, Evi Artsini

Radiology Department Faculty of Medicine

Gadjah Mada University - Dr. Sardjito Hospital
Yogyakarta
MODALITIES OF IMAGING

Imaging
with

Ionizing Ultrasound Magnetic

Radiation Resonance
 Imaging with

Ionizing Radiation

X Ray
• CONVENTIONAL
- Plain – Photo
- Tomography
- Digital Tomography
• ANGIOGRAPHIC STUDIES
- Conventional
- DSA
• CT-SCANNING
- Plain
- with Contrast
 SOFT TISSUE
TUMOR

BONE

EM
 ROLES OF IMAGING
1. Diagnosis
- the most propable D/DD
2. Extent
- local & metastatic
3. Follow up of treatment
4. Detect recurrences
 PLAIN PHOTO

LOW HIGH
KV TECHNIQUE KV TECHNIQUE
(≤ 50KV) (> 50KV)
- SOFT TISSUE - - BONE -
 WHAT TO DESCRIBE
I. ORIGIN OF LESION
II. DENSITY OF LESION
III. GENERAL CHARACTERS OF LESION
1. Location
2. Shape
3. Size
4. Margin
5. Number
IV. SPECIAL CHARACTERS & EFFECTS OF
LESION
I. ORIGIN OF LESION
• SOFT TISSUE
• BONE
SOFT TISSUE & BONE TUMOR

ENCHONDROMA
HAEMANGIOMA

MAFFUCI’S SYNDROME
SOFT TISSUE TUMOR
SOFT TISSUE TUMOR

SYNOVIAL SARCOMA
SOFT TISSUE MALIGNANT TUMORS

RELATION OF AGE TO INCIDENCE OF SARCOMA

CONGENITAL
TUMOR
DISORDERS
BENIGN BONE TUMOR - LYTIC LESION
ENCHONDROMA
BENIGN BONE TUMOR - SOLID LESION

OSTEOCHONDROMA
PRIMARY MALIGNANT BONE TUMORS

AGE GUIDELINES
PRIMARY MALIGNANT BONE TUMORS

OSTEOSARCOMA
PRIMARY MALIGNANT BONE TUMORS

DIAPHYSEAL OSTEOSARCOMA
II. DENSITY OF LESION

• LYTIC LESION
• SCLEROTIC LESION
III. GENERAL CHARACTERS OF LESION
4. MARGIN OF TUMOR
(ZONE OF TRANSITION)

1. NARROW
2. WIDE
3. PERMEATIVE
SHOWS
AGGRESSIVENESS not MALIGNANT
 NARROW Z.O.T.

CHONDROMYXOID FIBROMA
 WIDE Z.O.T.

FIBROSARCOMA
 IV. SPECIAL CHARACTERS AND
EFFECTS OF LESION

1. CORTICAL DESTRUCTION
2. PERIOSTITIS
BENIGN
AGGRESSIVE
3. AXIS OF LESION
IV.1. CORTICAL DESTRUCTION

BENIGN CHONDROBLASTOMA
 CORTICAL DESTRUCTION

JUXTACORTICAL CHONDROMA
 IV. 2. PERIOSTITIS

BENIGN AGGRESSIVE
 IV.3. AXIS OF LESION
1. LONGITUDINAL
2. TRANSVERSAL

?
 WHAT WE WANT TO BE ?

● RELIGIOUS
● CLINICIAN
● RADIOLOGISTS
RELIGIOUS
?
CLINICIAN
RADIOLOGIST
BASED ON PLAIN PHOTO CRITERIAS

BENIGN MALIGNANT most likely

D.D.
DENSITY, AGE & OTHER IMAGING
LOCATION GUIDELINES MODALITIES

MOST LIKELY DIAGNOSIS

BIOPSY/ PA FINDING

FINAL DIAGNOSIS
MAY GOD BLESS US
ALHAMDULILLAH
THANK YOU