Spine Bone Masses

Plasmacytoma/Multiple Myeloma

  • Painful

  • Findings

    • Expansile lytic lesion with cortex destruction

    • Bubbly appearance (“mini-brain appearance”)

    • No sclerotic reaction

  • T1: iso/hypo

  • T2: iso/hyper

  • Enhancement varies

Osteoblastoma

  • M>F

  • Required findings

    • Lytic lesion >2 cm

      • Not always true in my experience, can be sclerotic

    • Well defined borders

    • No host bone permeation

  • Locally aggressive

  • These are osteoid osteomas that are > 2cm

  • Enhancing (highly vascular)

  • T1 & T2: hypo/iso

Plasmacytoma/Multiple Myeloma

  • Locally aggressive

  • Age 20-50

  • Findings

    • Expansile lytic lesion with cortex destruction

    • Bubbly appearance (“mini-brain appearance”)

    • No sclerotic reaction

  • T1: iso/hypo

  • T2: iso/hyper

  • Enhancement varies

Langerhans Cell Histiocytosis

  • Young adults & older kids

  • Skull > pelvis > femur > spine

  • T1 & T2: hypo/iso

  • Vertebra Plana

    • Basically severe compression fracture

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