A bone tumor can be graded based on its appearance in radiographs. This can help decide if the lesion should be biopsied or if it can be safely followed. The authors are from the Department of Radiology at the University of Missouri at Columbia.
Parameters used:
(1) pattern of bone destruction
(2) edge characteristics
(3) presence or absence for penetration of cortex
(4) presence or absence of a sclerotic rim
(5) presence or absence of an expanded shell
Possible Grades:
(1) IA
(2) IB
(3) IC
(4) II
(5) III
|
Grade |
Destruction |
Edge Characteristic |
|
IA |
must be geographic |
(1) regular, or (2) lobulated, or (3) multicentric |
|
IB |
must be geographic |
(1) regular, or (2) lobulated, or (3) multicentric, or (4) ragged/poorly defined |
|
IC |
must be geographic |
(1) regular, or (2) lobulated, or (3) multicentric or (4) ragged/poorly defined, or (5) moth eaten <= 1cm |
|
II |
moth-eaten or geographic |
if geographic with moth eaten margin, then > 1 cm |
|
III |
must be permeated |
any |
(from Tables VIII and IX, page 583)
|
Grade |
Penetration of Cortex |
Sclerotic Rim |
Expanded Shell |
|
IA |
absent or partial; total excludes |
must be sclerotic; excluded if absent |
absent or <= 1 cm; excluded if > 1 cm |
|
IB |
absent or partial; total excludes |
absent or present (optional) |
if sclerotic rim present, expanded shell must be > 1 cm; excluded if < 1 cm |
|
IC |
must be total |
absent or present (optional) |
absent or any size (optional) |
|
II |
must be total |
absent or present (optional), but unlikely |
absent or any size (optional), but unlikely |
|
III |
must be total |
absent or present (optional), but unlikely |
absent or any size (optional), but unlikely |
(from Tables VIII and IX, page 583)
Specialty: Hematology Oncology, Surgery, general, Surgery, orthopedic
