(Left) Thoracolumbar anteroposterior radiograph demonstrates sclerotic focus 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.
(Right) Axial bone CT of the thoracic spine reveals a focal sclerotic bone lesion with characteristic dense sclerosis and irregular, brush-like margins of the vertebral body bone island.
(Left) Sagittal T1WI MR demonstrates a small focal area of very low signal intensity within the anterior L4 body , without reactive marrow change or osseous destructive changes to imply an aggressive lesion.
(Right) Sagittal T2WI MR displays a small focal area of very low signal within the anterior L4 body , 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
Small focal areas of sclerosis, with feathered or brush-like margins, in cancellous bone
• Location
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
1 mm to several cm
• Morphology
Round, well-defined margins
Radiographic Findings
• Radiography
Single or multiple areas of focal homogeneously dense sclerotic foci in cancellous bone
Distinctive radiating bony streaks (“thorny radiation”) blend with trabeculae of host bone
CT Findings
• NECT
Findings similar to plain radiography, without demonstrable soft tissue component
MR Findings
• T1WI
Focal low signal intensity
• T2WI
Focal low signal intensity
• T2* GRE
Low signal + slight “blooming” effect due to susceptibility artifact
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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.
with characteristic dense sclerosis and irregular, brush-like margins of the vertebral body bone island.
, without reactive marrow change or osseous destructive changes to imply an aggressive lesion.
, without reactive marrow change or other worrisome marrow abnormality. Lack of destructive change and soft tissue mass favor bone island.
