Osseous Lesions: What to Know and What to Expect

Osseous lesions refer to bone abnormalities typically identified through medical imaging. While most of these abnormalities are benign, the term covers a wide range of bone conditions, which may require further testing for a definitive diagnosis. This guide will explore the most common types of osseous findings, review the imaging methods used to detect them and outline what to expect during these scans.

While this guide provides helpful information, if you have osseous lesions, your doctor will give the official interpretation of your results during a follow-up appointment or phone call. However, if you’d like early access to your results, PocketHealth offers secure, instant access to your report when it is available. This allows you to review the findings prior to your follow-up appointment and prepare any questions for your follow-up appointment.

 

 

What are osseous lesions?

The term osseous refers to bone, so the two words can be used interchangeably. An osseous lesion refers to irregular bone growth or damage. It is a broad term that covers various conditions, including injuries, infections or even tumors. While some bone tumors can be cancerous, most turn out to be benign and treatable. Because there are so many varieties of bone lesions, this guide will quickly overview the more common types.

 

Types of bone lesions

Here are some of the more common types of bone lesions, growths and tumors. Remember, a tumor doesn’t always indicate cancer. In fact, most bone tumors are benign and highly treatable.

• Enchondroma: This benign growth forms within the cartilage of the bone, most commonly in the feet and hands. Because they usually don’t cause symptoms, they are often discovered incidentally during an unrelated X-ray. In some cases, they may cause fractures or pain if the growth weakens the surrounding bone or becomes too large. In such instances, treatment typically involves surgical removal of the tumor.
• Unicameral bone cysts: Similar to enchondromas, these are primarily found in children and usually don’t require treatment unless the growth affects the surrounding bone health.
• Osteochondroma: This common osseous growth primarily affects children and young adults. It occurs when a bone tumor develops near the growth plate at the end of long bones or other areas. Typically, it doesn’t require treatment and is often asymptomatic. Doctors may monitor it for any changes, taking surgical action on the rare occasion that the tumor causes complications.
• Giant cell tumor: This rare, noncancerous tumor can damage bone tissue if left untreated. It is usually found at the end of a long bone, such as the femur. Treatment typically involves surgery to remove the tumor, along with monitoring for any recurrence.
• Other benign tumors: There are many types of benign bone tumors. Most require no intervention unless the growth affects the surrounding bone, in which case surgical removal of the tumor is typically the standard treatment.
• Cancerous bone tumors: While most bone tumors are benign, some osseous lesions can signal certain bone cancers, including chondrosarcoma, Ewing sarcoma, multiple myeloma and osteosarcoma.
• Bone cysts: These fluid-filled cavities are usually benign and harmless but can be surgically removed if they negatively affect surrounding bone structures.
• Bone spurs (osteophytes): These hard growths typically result from joint damage or repetitive stress on the bones. They occur as the bone repairs itself, adding additional bone to the injured area. Osteophytes are quite common, especially with age, and usually don’t cause symptoms. When they do cause discomfort or complications, they can be surgically removed.

 

Symptoms of osseous lesions

Because many osseous lesions are asymptomatic, they often go undiagnosed or are discovered incidentally during an unrelated scan. For lesions that do cause symptoms, some of the most common include:

• Pain or dull aches at the site of the lesion
• Swelling or inflammation
• Fractures caused by the lesion weakening the surrounding bones
• Decreased mobility or range of motion, such as in the limb with the affected bone

 

Causes of bone lesions

In many cases, the cause of a bone lesion is unknown. It depends on the type of lesion and the patient’s medical history. Possible causes include injuries, uncontrolled cell division, genetics, radiation treatments that affect the bones and even normal signs of aging. Because there are so many different contributing factors, treatments for these growths vary based on the specific lesion type the patient is experiencing.

 

How are osseous lesions diagnosed?

Medical imaging is typically required to discover and diagnose osseous lesions, sometimes followed by a bone biopsy if the physician deems it necessary to gather more information and have the bone tested. Several scanning methods are available, each with its strengths and limitations. Providers may use more than one type if additional detail is needed. Here is a brief overview of the most common imaging techniques used for bone lesions.

X-ray scans

X-rays use small amounts of radiation to capture images of a patient’s internal structures, including bones. As the radiation beams pass through the body, they interact differently based on the density of the area being scanned. For example, dense areas like bone appear white on the images, while muscle and fat show up as gray, and hollow areas, such as the lungs, appear black. While X-ray reports can reveal a variety of internal conditions, they are especially effective at providing clear images of bone and skeletal structures.

MRI scans

Magnetic resonance imaging (MRI) uses magnetic fields and radio waves to capture internal images. MRIs provide a high level of detail, making them well-suited for assessing a variety of soft tissue and skeletal structures. However, they can be more expensive and harder to schedule than X-rays. Due to their magnetic nature, MRIs should not be performed around metal, so patients with metallic implants may need to use an alternative imaging method.

CT scans

Computerized tomography (CT) scans use the same imaging technology as basic X-rays, but with a key difference: while traditional X-rays take 2-dimensional images, CT scans capture images from multiple angles to create 360-degree views. This results in more detailed images. X-rays, including CT scans, expose patients to low levels of radiation, though they are considered to be within safe parameters. CT scans involve slightly more radiation, but it remains well within safe levels as long as they are not frequently repeated. For this reason, CT scans are well-suited for occasional imaging. However, if regularly recurring scans are needed, an alternative method, such as an MRI, is often recommended.

Bone scans

Also known as skeletal scintigraphy, bone scans use a substance called a radiotracer, which is injected into the patient’s body. An imaging machine with a gamma camera then scans the patient, capturing images that show how the radiotracer is absorbed by tissues, bones and other areas. The way these areas absorb this substance can help indicate various underlying conditions, assisting medical providers in narrowing down a diagnosis or determining the next steps to take.

 

 

Preparing for your bone imaging

Here are some helpful tips when preparing for your bone scan. Depending on the type of scan your doctor recommends, there may be preparations specific to that imaging method. It can be helpful to ask in advance for any requirements:

• Review any preparatory instructions: Doing this well in advance helps ensure no important preparations are missed.
• Bring your requisition form: If the imaging clinic doesn’t already have your scan orders on file, this can save you time checking in. Also bring your health or insurance card and photo ID.
• Wear comfortable clothes: Often, patients are allowed to stay in their clothes for scans, as long as they avoid metal and other obstructions. Regardless, wear something comfortable and easy to change in and out of, in case a hospital gown is required.
• Inform your doctor if you think you may be pregnant: Provide this information well in advance if possible. Some imaging methods may not be recommended for pregnant patients, in which case your medical provider may substitute a different imaging technique.

 

Getting my results

The imaging technician is not generally allowed to discuss results during the scan. They can answer questions about the appointment itself, but not about the imaging results. Here are some common questions regarding getting osseous imaging results back.

When will I get my results?

Turnaround times for results can vary widely depending on the facility and your doctor’s availability. Often, patients wait a week or more and receive their results during a follow-up appointment. With PocketHealth, you don’t have to wait as long—your results are available securely as soon as the report is written and uploaded, allowing you to review them often before your follow-up visit.

Who interprets my results?

A radiologist—an expert in interpreting medical images—will carefully review your osseous scans and provide a detailed report of any findings. This report is then sent to your referring doctor, who, with a deeper understanding of your medical history, can offer additional insights and recommendations based on the results.

 

Understanding your results

It’s common to find medical terminology somewhat confusing, but Report Reader helps you to better understand your report by offering clear, straightforward definitions for medical terms—simply tap or click on any underlined words to reveal their meaning.

For patients seeking to understand bone lesion results, this guide will briefly cover common terminology found in these types of scans. That said, your medical provider will provide any official interpretations of your results.

Bone lesion terminology and results:

Here is some information and terminology found within many bone lesion reports:

• Size and location: If a lesion or growth is found, the location and size will be noted.
• Shape of the lesion and its borders: The shape of the lesion may provide clues about the type of growth. For instance, well-defined borders are usually a sign of a benign tumor.
• Surrounding bone health: If the bone around the lesion appears fractured or damaged, it may indicate that the lesion needs to be removed, even if it is benign. If the adjacent areas look healthy, monitoring may be sufficient, and treatment may not be necessary.
• If inflammation is present: Inflammation can indicate injury or infection, allowing the provider to assess whether treatment is needed.
• No osseous findings: Terms such as “no acute findings” or “no positive findings” indicate that the bone scan showed normal results with no abnormalities.

 

Frequently asked questions

Here are some commonly asked questions regarding osseous lesions.

Can a bone lesion turn into cancer?

Rarely, a benign bone lesion can become malignant over time if cells continue to divide abnormally. Fortunately, this is uncommon. When a doctor is aware of a benign bone lesion, they typically monitor the patient regularly to check for any suspicious changes. This approach ensures that if cancer does begin to form, it can be detected in its early stages when it is highly treatable.

How is a bone biopsy performed?

If bone imaging doesn’t provide enough detail on an osseous lesion, a medical provider may recommend a bone biopsy for further testing. There are two methods:

• Needle biopsy: This procedure is performed with a local anesthetic. A long, thin needle is inserted into the bone to remove a small sample for study. The biopsy may be guided by MRI or CT scan if necessary, to help the physician pinpoint the lesion. Patients typically resume normal activities the same day.
• Open biopsy: The bone sample is removed through an incision while the patient is under general anesthesia. This method is used when a larger sample is needed for testing. Depending on the size of the sample and any underlying health conditions, the patient may go home the same day or stay overnight in the hospital.

While both procedures may seem intimidating, they are generally considered safe with minimal risks. Recovery time is usually up to a week. If your doctor recommends a biopsy, be sure to ask them any questions you may have.

Can bone lesions be prevented?

Currently, there is no known way to prevent the formation of bone lesions. Since they can sometimes affect surrounding skeletal structures, maintaining a healthy lifestyle may help support overall bone density and health. However, it’s important to consult your doctor for specific recommendations, as each patient and situation is unique.

What is the outlook for osseous lesions?

Since most bone lesions are benign, the outlook is generally quite favorable for patients with these conditions. When a lesion causes problems, surgery is often a successful treatment. For malignant lesions, early detection offers a good prognosis for recovery. Additionally, the medical field is exploring promising new treatments that may help treat or even regenerate cancerous bone.

 

Take control of your health journey

PocketHealth makes it simple to keep track of your bone scan reports and other medical results. All of your vital imaging is in one secure location and can be accessed online anytime. If needed, reports can also be easily shared with other physicians in your care team. When used in conjunction with your medical provider’s professional advice, it is a powerful tool for organizing and understanding your imaging results and your health.

Another tool for your health is MyCare Navigator, which provides personalized insights to your health and identifies any recommended follow-up steps. This feature can also generate individualized questions to ask your doctor based on the findings in your report, ensuring you make the most of your consultation.