Bone Tumor
IMAGING
General Features
Radiographic Findings
Centrally or eccentrically located within bone
Expansile or nonexpansile
Osteolytic, osteosclerotic, or mixed pattern
Well-defined margin (narrow zone of transition)
Ill-defined margin (wide zone of transition)
± cortical breach
± extraosseous tumor expansion
± periosteal ± tumoral new bone formation
Many types of periosteal or tumoral new bone formation
Type of periosteal reaction is not highly sensitive discriminator of tumor aggressiveness
Spiculated, “sunburst,” and “hair-on-end” tumoral new bone are highly specific for aggressive tumor
Ultrasonographic Findings
US appearances generally mirror radiographic appearances
Bone metastases are most common bone tumor encountered in routine clinical practice
Can be done for all tumors irrespective of whether primary tumor is visible on US
Flow velocities can be calculated
Normal arterial flow is triphasic with reversal of flow in diastole
Metabolically active tumors may show substantial ↑ in antegrade diastolic flow
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of the distal radial metaphysis indicative of an aggressive bone lesion. There is a faint periosteal reaction 
.
of the distal radial metaphysis with a surprisingly large extraosseous component. The tumor clearly extends beyond the physis.
of new bone suggestive of an osteogenic tumor. There is an ultrasonic Codman triangle 
at the proximal end of the tumor.
. This finding is seen in various bone tumors and is not unique for osteosarcoma, though US-guided biopsy did reveal osteosarcoma in this case.
