Bonnes pratiques en imagerie dans les tumeurs osseuses

Assessment of bone tumours by imaging may require the use of all radio-diagnostic techniques. X-ray remains essential. It assesses the progression of the lesion and is useful in considering one or more diagnoses on the basis of morphological and topographic criteria. CT-scanning is used for spatial resolution by exploring anatomic areas insufficiently visualized by X-ray; this technique is reliable for the study of bone cortex and tumour matrix. Contrast resolution and multiple plan acquisition which are useful for analysing tumour spread, are the major assets of MRI. Bone scintigraphy is of special interest in determining whether there is one lesion or more. US-scan, angiography, interventional radiology have specific indications. Depending on the radiographic characteristics of the tumour, several attitudes are recommended, varying from the absence of any additional investigation when benignity is obvious, to complete staging, prior to biopsy, in case malignant tumour is suspected.