Primary Tumours of the Posterior Elements of the Spine

• Primary Tumour of the Posterior Elements of the Spine¹
  • Age at Presentation
    • Young children; adulthood
      • Osteochondroma
        CT: Sessile or pedunculated osseous cauliflower lesion with corticomedullary continuity with parent bone
        MR: Central high T1 marrow, low T1 cortex. T2 bright cartilage cap (chondroid). Occasional septal enhancement in cartilage cap.
    • 20 – 30
      • Osteoid Osteoma
        CT: Dense sclerotic bone growth with a vascularised nidus that may centrally calcify. Lamellar periosteal reaction may be present. < 2cm (otherwise osteoblastoma).
        MR: Low T1, variable T2/STIR, diffuse enhancement
    • 30 – 40
      • Tenosynovial Giant Cell Tumour
        Locally aggressive and proliferative benign lesion affecting synovium of tendon sheaths, bursae, and joints.
        CT: Circumscribed hyperattenuating soft tissue mass, bone erosions, periosteal reaction, intralesional calcifications.
        MR: Variable T1/T2. Heterogenous enhancement.
    • 50 – 60
      • Solitary Bone Plasmacytoma
        CT: Small lytic bone lesion in vertebral body, pathologic compression fracture common.
        MR: T1 iso- to hypointense, T2/STIR hyperintense. Homogenous enhancement.
    • 60 – 80
      • Multiple Myeloma
        CT: Multifocal lytic lesions, diffuse osteopaenia, vertebral compression fractures
        MR: Low to intermediate T1, hyperintense T2/STIR, diffuse or heterogenous enhancement

• Classification of Primary Bone Tumours²
  • Osteogenic
    • Benign
      • Osteoid Osteoma
      • Osteoblastoma
    • Malignant
      • Osteosarcoma
  • Chondrogenic
    • Benign
      • Osteochondroma
      • Chondroblastoma
      • Chondromyxoid Fibroma
    • Malignant
      • Chondrosarcoma
  • Vascular
    • Benign
      • Haemangioma
      • Lymphangioma
    • Malignant
      • Haemangioendothelioma
      • Haemangiopericytoma
  • Haematopoietic
    • Malignant
      • Plasmacytoma
      • Multiple Myeloma
      • Lymphoma
      • Leukaemia
  • Notochord
    • Malignant
      • Chordoma
  • Giant Cell
    • Benign
      • Giant Cell Tumour
  • Ewings Sarcoma
    • Malignant
      • Ewings Sarcoma
      • Primitive Neuroectodermal Tumour

References

1. Anaya, J.E., Coelho, S.R., Taneja, A.K., Cardoso, F.N., Skaf, A.Y. and Aihara, A.Y., 2021. Differential diagnosis of facet joint disorders. Radiographics, 41(2), pp.543-558. ↩︎
2. Patnaik, S., Jyotsnarani, Y., Uppin, S.G. and Susarla, R., 2016. Imaging features of primary tumors of the spine: A pictorial essay. Indian Journal of Radiology and Imaging, 26(02), pp.279-289. ↩︎