Pseudolesions referred to an orthopedic oncologist: A Review

Purpose: In spite of recent advances in radiological imaging, characterizing and discriminating focal lesions can still present as a challenge to radiologists. Pseudolesions are focal abnormalities that can mimic true lesions. They are encountered in routine imaging studies frequently. Some of these focal lesions may be true neoplasms, others may just appear so on imaging. These may be due to infection, congenital abnormalities, iatrogenic lesions, artifacts, and arthritic changes associated with an imaging modality.

We investigate pseudolesions and their radiological characteristics through a case based review.

Methods/Materials: A comprehensive PUBMED search was conducted using key words relevant to pseudolesions and orthopedic oncology that fit into the following categories: normal variants, congenital, iatrogenic and degenerative.

Results: Numerous pseudolesions found throughout the musculoskeletal system and how they appear on different imaging modalities are discussed, which can be mistaken for true pathology.

Conclusions: It is essential for both the radiologist and provider to realize the difference between pseudolesions and malignant lesions. By considering the patient’s past medical history, prior imaging, and physical exam, the radiologist can avoid this pitfall. Having the skillset to determine if a lesion should need further workup is necessary in order to prevent misdiagnosis, unnecessary procedures, and additional medical costs.