Principles of Musculoskeletal Imaging in Cancer

Tumors arising from the musculoskeletal system include benign and malignant neoplasms. Benign etiologies include posttraumatic, infectious, and inflammatory conditions. Malignant neoplasms include primary tumors of the soft tissue and the bone. Metastatic disease to the musculoskeletal system may present as soft tissue masses, bone destruction, or marrow replacement. The choice of a radiologic diagnostic imaging test takes into account the sensitivity of each modality as it pertains to the patient’s cancer history, presentation, and clinical query. The entire skeletal system is evaluated with a whole-body nuclear medicine bone scan. Musculoskeletal imaging to evaluate cancer patients requires complementary exams to diagnose patients and evaluate treatment response. The most important are the availability of prior scans for comparison and a detailed history of treatment and current medication to allow the interpreting radiologist the ability to provide a thorough comprehensive detailed consultation.