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J Korean Soc Radiol. 2015 Oct;73(4):240-248. English. Original Article. https://doi.org/10.3348/jksr.2015.73.4.240
Bae JH , Lee IS , Song YS , Kim JI , Cho KH , Lee SM , Lee YH , Song JW .
Department of Radiology, Pusan National University School of Medicine, Pusan National University Hospital, Busan, Korea. lis@pusan.ac.kr
Department of Orthopaedic Surgery, Pusan National University School of Medicine, Pusan National University Hospital, Busan, Korea.
Department of Radiology, Yeungnam University College of Medicine, Yeungnam University Medical Center, Daegu, Korea.
Department of Radiology, Keimyung University College of Medicine, Dongsan Medical Center, Daegu, Korea.
Department of Radiology, Catholic University of Daegu College of Medicine, Daegu Catholic University Hospital, Daegu, Korea.
Department of Radiology, Inje University College of Medicine, Haeundae Paik Hospital, Busan, Korea.
Abstract

PURPOSE: To determine whether benign and malignant bone tumors with associated pathologic fractures can be differentiated using radiologic findings. MATERIALS AND METHODS: Seventy-eight patients (47 men and 31 women, age range: 1-93 years) with a bone tumor and an associated pathologic fracture from 2004 to 2013 constituted the retrospective study cohort. The tumor size, margin, and enhancement patterns; the presence of sclerotic margin, the peritumoral bone marrow, soft tissue edema, extra-osseous soft tissue mass, intratumoral cystic/hemorrhagic/necrotic regions, mineralization/sclerotic regions, periosteal reaction and its appearance; and cortical change and its appearance were evaluated on all images. Differences between the imaging characteristics of malignant and benign pathologic fractures were compared using Pearson's chi-square test and the 2-sample t-test. RESULTS: There were 22 benign and 56 malignant bone tumors. Some factors were found to significantly differentiate between benign and malignant tumors; specifically, ill-defined tumor margin, the presence of sclerotic tumor margin and an extra-osseous soft tissue mass, the absence of cystic/necrotic/hemorrhagic portions in a mass, the homogeneous enhancement pattern, and the presence of a displaced fracture and of underlying cortical change were suggestive of malignant pathologic fractures. CONCLUSION: Some imaging findings were helpful for differentiating between benign and malignant pathologic fractures.

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