Bone Island

(Left) Thoracolumbar anteroposterior radiograph demonstrates sclerotic focus image within the lower thoracic vertebral body, adjacent to the pedicle. There is characteristic nonaggressive appearance with sclerotic density and brush-like margins that suggest bone island.

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(Right) Axial bone CT of the thoracic spine reveals a focal sclerotic bone lesion image with characteristic dense sclerosis and irregular, brush-like margins of the vertebral body bone island.
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(Left) Sagittal T1WI MR demonstrates a small focal area of very low signal intensity within the anterior L4 body image, without reactive marrow change or osseous destructive changes to imply an aggressive lesion.

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(Right) Sagittal T2WI MR displays a small focal area of very low signal within the anterior L4 body image, without reactive marrow change or other worrisome marrow abnormality. Lack of destructive change and soft tissue mass favor bone island.

TERMINOLOGY

Synonyms

• Enostosis, sclerotic island, calcified island, compact island

Definitions

• Asymptomatic focal areas of bony sclerosis

IMAGING

General Features

• Best diagnostic clue
image Small focal areas of sclerosis, with feathered or brush-like margins, in cancellous bone
• Location
image Found in any skeletal bone
– Most common in pelvis, femur, ribs, long bones
– Less common in spine; may involve vertebral body or posterior elements
• Size
image 1 mm to several cm
• Morphology
image Round, well-defined margins

Radiographic Findings

• Radiography
image Single or multiple areas of focal homogeneously dense sclerotic foci in cancellous bone
image Distinctive radiating bony streaks (“thorny radiation”) blend with trabeculae of host bone

CT Findings

• NECT
image Findings similar to plain radiography, without demonstrable soft tissue component

MR Findings

• T1WI
image Focal low signal intensity
• T2WI
image Focal low signal intensity
• T2* GRE
image Low signal + slight “blooming” effect due to susceptibility artifact

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Oct 5, 2016 | Posted by in NEUROLOGICAL IMAGING | Comments Off on Bone Island

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