skeletal manifestations of eosinophilic granuloma (eg)
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short notes about Skeletal manifestations of eosinophilic granuloma (EG) summarized by Dr laith fadhel / radiologistTRANSCRIPT
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Skeletal manifestations of eosinophilic granuloma (EG)
Presented by Dr.laith Fadhel
reference David Sutton 1340
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• Epidemiology /The skeletal system is the commonest site of involvement of Langerhans cell histiocytosis, and in for 60-80% of cases is the only organ system involved.
• Aged affected / children 3-12 years / young adult / male predominance • location / skull , pelvis , femora , diaphysial predilection • Symptoms / pain , swelling , fever • Presentation / solitary , multiple lesions • Radiological sign / lucent area of bone distraction , Sharpe oval or scalloped margin , bone expansion , in chronic phase with sclerotic margin , collapse vertebra • DDX / osteomyelitis , Ewing's tumor , in spine / metastases , atypical TB , neuroblastoma
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Skull
1. Isolated lesion 2. Bone expansion 3. Sharpe margin Oval ,
scalloped 4. DDX / epidemoid or
fibrous dysplasia
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Spine
1. collapse vertebra { vertebra plana }
2. wall bulging laterally 3. disc intact 4. Para spinal soft shadow
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Spine
1. collapse vertebra { vertebra plana }
2. wall bulging laterally 3. disc intact 4. Para spinal soft shadow5. CT / cortical erosion and
soft tissue involvement
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Spine MRI / T1 - typically low signal T2 - isointense to hyper intense STIR - hyper intenseT1 C+ (Gd) - often shows contrast enhancement
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PT Bone scanVariable appearance on bone scintigraphy with lesions showing an increased or decreased tracer uptake depending on the histological picture. Nonetheless bone scans are helpful in other asymptomatic lesions.