Musculoskeletal Tumors: To Touch or Not to Touch? (2021)-T6-CMK07-2021

Video Transcription

Video Summary

The video, led by Laura Fayad, discusses identifying abnormal bone marrow signals on MRI, with a focus on pediatric heel pain. It highlights the dynamic nature of bone marrow, which transitions from hematopoietic red marrow to fatty yellow marrow as a child matures to an adult. Fayad emphasizes the importance of T1-weighted MRI sequences, where fatty marrow appears bright, to contrast and identify marrow-replacing abnormalities such as osteosarcoma. The talk explains normal developmental signals in children's bones and the significance of age and location in assessing bone marrow changes.<br /><br />Different marrow disorders such as red marrow reconversion—often due to anemia or obesity—are considered. Recognition of abnormal marrow signals, especially those extending to bone ends, is crucial to ruling out serious conditions like myeloma. Identifying marrow-replacing processes, like metastatic diseases, requires specialized imaging sequences. Fayad stresses using additional marrow-specific sequences such as chemical shift imaging and diffusion-weighted imaging to diagnose conditions accurately.<br /><br />Other parts of the seminar discuss differentiating malignant soft-tissue lesions from benign ones, focusing on myxoid liposarcoma and hemorrhagic neoplasms. It also touches on common PET-CT pitfalls, highlighting misdiagnosed conditions like elastofibroma, vaccine reactions, and uptake in benign conditions like adhesive capsulitis. Lastly, it covers analyzing bone lesions using margin assessments to determine their aggressiveness and appropriate follow-up recommendations. Overall, careful imaging interpretation is critical to avoiding misdiagnosis and ensuring patient safety.

Keywords

bone marrow MRI

pediatric heel pain

T1-weighted sequences

osteosarcoma

red marrow reconversion

myeloma

metastatic diseases

chemical shift imaging

myxoid liposarcoma

PET-CT pitfalls