X-ray is an important method for examining bone tumors

X-ray examination of bone tumors can provide valuable information for clarifying the nature, type, and scope of bone tumors and determining treatment guidelines. It is an important examination method for bone tumors. However, X-ray films are only projections of bone tumors. The X-ray manifestations of bone tumors are not constant and require close combination with clinical manifestations and pathological examinations to make an accurate diagnosis.

X-rays can provide doctors with four pieces of information about the tumor progression process:

1. The location of bone tumors. Tumors can be located in the epiphysis, the metaphysis, the long bones, or the flat bones. Tumors occurring in the epiphysis of adolescents should first be considered as chondroblastomas, while tumors occurring in the above epiphysis of adults should be considered as giant cell tumors of bone.

2. The impact of tumor on host bone The presence or absence of infiltration at the boundary between tumor and host bone is the primary factor in determining the nature of the lesion. A clear boundary indicates that the tumor grows slowly and has weak infiltration. On the contrary, a blurred boundary indicates that the tumor has strong infiltration.

3. Host response to tumors: The host always tries to destroy the tumor by wrapping it to form a fibrous tissue capsule. Rapidly growing tumors can infiltrate and destroy this reactive bone capsule, and the remnants of this capsule can only be seen at one or both ends of the tumor, usually appearing as a Codman triangle.

4. Density of tumor tissue: Any changes in density during bone tissue imaging may indicate that the tissue is diseased. Some tumors are osteolytic lesions, such as giant cell tumor of bone, while others are osteoblastic lesions with irregular or snowflake-shaped bone formation, such as osteosarcoma and chondrosarcoma.

When tumors occurring in the pelvis, spine and other parts of the body cannot be displayed well by ordinary X-rays, new imaging technologies such as CT scans, B-ultrasound, MRI, ECT and so on can help determine the location and extent of the tumor.

Bone scans can show the presence of primary and secondary bone tumors before ordinary X-rays show positive changes. For suspected cases, 99-technetium bone scans should be performed selectively.