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Musculoskeletal Imaging

E2708. It’s What’s On the Outside That Counts: Lesions Involving the Outer Surface of Bone

Hollenberg G,  Meyers S. University of Rochester Medical Center, Rochester, NY

Address correspondence to S. Sims (

Background Information: The causes of lesions involving the outer surface of bone run the gamut from degenerative disease to benign tumors to inflammatory processes to malignant masses. The multiplicity of these lesions can present a diagnostic challenge.

Educational Goals/Teaching Points: The purpose of this exhibit is to familiarize the reader with some of the most frequently seen as well as some rare lesions of the outer surface of bone. We compare and contrast the key imaging features of these lesions to aid the reader in developing a differential diagnosis. Pathologic slides are presented to enhance the radiologist’s understanding of the in vivo manifestations of the disease process.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques: This presentation reviews primary juxtacortical osseus lesions with respect to the radiographic, CT, and MRI features. Salient imaging and clinical features of these lesions are included. Pathologic entities reviewed include juxtacortical chondroma, synovial and ganglion cysts, chondromyxoid fibroma, periosteal osteoid osteoma, parosteal lipoma, pigmented villonodular synovitis, juxtacortical chondrosarcoma, juxtacortical osteosarcoma, and hemangioendothelioma. Pathologic slides are included where available.

Conclusion: Lesions of the outer surface of bone are multiple and diverse. This presentation outlines the imaging characteristics (and where available, the pathologic findings) of a variety of common and rare entities.