Bone metastases

53 Bone metastases



Background


Bone metastases are aggressive lesions (see Chapter 49). It is important to detect them as their presence will have an impact on further management.


Always look at the bones, on any plain radiograph (this includes CXR, AXR etc.), for bone metastases.


Bone metastases may present with bone pain, or be asymptomatic. They may present as a pathological fracture (see Chapter 47).



Radiological features


Bone metastases may be lytic (lucent), sclerotic (increased density) or mixed (elements of lytic and sclerotic). These properties can be used to help determine the tumour of origin if this is not known:


• lytic metastases: causes include lung, breast, renal cell, thyroid and bowel cancer, melanoma, myeloma and lymphoma

• sclerotic metastases: causes include prostate cancer

• mixed metastases: causes include breast cancer.

Bone metastases can have a wide variety of appearances and this account is not exhaustive.



image

Fig. 53.1 Bone metastasis. This patient has a lytic metastasis in the distal femur. The primary tumour in this case was lung cancer. Note the aggressive features (see Chapter 49).


Remember that metastases weaken bone and that this patient is at risk of a pathological fracture. Refer to orthopaedics for prophylactic pinning before this happens.

Related posts:

Permanent pacemakers Gastric outlet obstruction Caecal volvulus Small bowel obstruction Brodie’s abscess Slipped upper femoral epiphysis

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Aug 20, 2016 | Posted by in ULTRASONOGRAPHY | Comments Off on Bone metastases

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