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Bone Metastases 2: Pelvis and Appendicular Skeleton

  • Chapter
Imaging of Bone Tumors and Tumor-Like Lesions

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

Key Points

• Metastatic bone disease is the commonest bone malignancy in the adult ≥40 years of age.

• The occurrence of bone metastases is a sign of poor prognosis, and major complications due to bone metastases are common and include hypercalcaemia and pathological fracture.

• Fracture risk can be assessed utilising clinical criteria and radiographs using the Mirels score.

• Bone lesions, especially if solitary, cannot be assumed to be metastases even in patients with a known primary malignancy.

• Biopsies should be performed in a dedicated bone tumour centre.

• The main aim of all treatments must be to relieve pain and restore function; patient management benefits from a multidisciplinary approach.

• Follow-up imaging after treatment is challenging for the radiologist and requires detailed knowledge about the treatment and possible outcomes and complications.

• Bone metastases can occur within any bone in any location.

• The morphology of bone metastases is extremely varied and unspecific; in many cases histological confirmation is indicated.

• Radiographs are relatively insensitive and unspecific but still a valuable first-line investigation for focal pain.

• Bone scintigraphy is a simple and inexpensive screening test for bone metastases, but specificity and less so sensitivity are limited.

• PET–CT and whole-body MRI offer good sensitivity and specificity but are expensive and not universally available.

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Authors and Affiliations

  1. Department of Radiology, The Robert Jones & Agnes Hunt Orthopaedic and District Hospital NHS Trust, SY10 7AG, Oswestry, Shropshire, UK

    Bernhard J. Tins, Radhesh K. Lalam, Victor N. Cassar-Pullicino & Prudencia N. M. Tyrrell

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  1. Bernhard J. Tins
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  2. Radhesh K. Lalam
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  3. Victor N. Cassar-Pullicino
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  4. Prudencia N. M. Tyrrell
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Editor information

Editors and Affiliations

  1. MRI Department, Royal Orthopaedic Hospital, NHS Foundation Trust, Bristol Road South, Northfield, B31 2AP, Birmingham, UK

    A. Mark Davies

  2. Section of Musculoskeletal Radiology, Imaging Institute, Diagnostic Radiology/A21, School of Medicine of Case Western Reserve University, Cleveland Clinic Foundation, 9500 Euclid Ave., 44195, Cleveland, OH, USA

    Murali Sundaram

  3. Imaging Department, Royal Orthopaedic Hospital, NHS Foundation Trust, Bristol Road South, Northfield, B31 2AP, Birmingham, UK

    Steven L. J. James

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© 2009 Springer-Verlag Berlin Heidelberg

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Tins, B., Lalam, R., Cassar-Pullicino, V., Tyrrell, P. (2009). Bone Metastases 2: Pelvis and Appendicular Skeleton. In: Davies, A., Sundaram, M., James, S. (eds) Imaging of Bone Tumors and Tumor-Like Lesions. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-77984-1_27

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  • DOI: https://doi.org/10.1007/978-3-540-77984-1_27

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-77982-7

  • Online ISBN: 978-3-540-77984-1

  • eBook Packages: MedicineMedicine (R0)

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