SUNRAY APPEARANCE

SUNRAY APPEARANCE

A pattern consisting of

central disk with radiating calcified spicules projecting

in manner of sunbeam,

LESIONS which show sunray

appearance are:

1)Arterial/plexiform

hemangioma.

2)Chondrosarcoma.

3)Osteosarcoma.

4)Ewing’s sarcoma

5)Neuroblastoma.

6)Burkitt’s lymphoma

ARTERIAL /PLEXIFORM HEMANGIOMA

It is a type of congenital fistula.There is a pulsatile swelling of the arteries,veins become tortous and thick walled.

R/F(SITE)

Commonly found in mandible_inferior

canal

SUNRAY OR SUNBURST APPEARANCE

The large lesion may cause cortical expansion with radiating spicules at the expanding periphery,occasionally producing

the sunray or sunburst appearance.

SOAP BUBBLE/HONEY COMB APPEARANCE

Well defined zone of radiolucency is present within which trabecular spaces get enlarged and the trabeculae themselves become coarse and thick.The lesion,therefore,presents typically a multicystic,soap bubble appearance.

SPOKES OF WHEEL APPEARANCE

The structure of the bone is changed in the affected area so that the trabeculae are arranged in a manner which has a rough

resemblance to the spokes of wheels.

PHLEBOLITHS

Small area of calcifications occasionally within the surrounding soft tissues are seen.

EFFECT ON ADJACENT STRUCTURES

Root resorption .

Inferior alveolar canal.

Mandibular and mental foramen.

CHONDROSARCOMA

It develops from natural cartilage or benign cartilaginous tumour.

RADIOGRAPHIC FEATURES

Radiodensity-scleorotic or mixed.

Poorly defined borders.

Shape-round,ovoid or lobulated

Sunray appearance-peripheral periosteal new bone may be present perpendicular to the orignal cortex giving sunray appearance.

SNOW LIKE APPEARANCE

It may be Multi loculated or develop as multiple radiolucency containing radioopaque foci.The centre radioopaque structure has been implied snow like features.

SOAP BUBBLE APPEARANCE

Large lobules of cartilage may give a radiolucent soap bubble appearance.

GROUND GLASS APPEARANCE

Diffuse calcifications may be superimposed on a bony background that resembles ground glass appearance.

SPECKLED APPEARANCE

Central radiolucent nidus which is probably cartilage,surrounded by calcifications

Teeth may be band like,widening of PDL and resorption of roots.

Condylar lesion.

Mandibular lesion.

Maxillary lesion.

OSTEOSARCOMA

Malignant tumour of the bone

derived from osteoblast in

which tumour cells contain high

level 0f alkaline

phosphatase

R/F

There are types:

frankly osteolytic.

mixed

osteoblastic

OSTEOLYTIC

Ill defined margins.

Moth eaten appearance.

Spiking resorption of roots.

Sarcoma develop near maxillary sinus.

Lamina dura destroyed.

MIXED

Margins are not well defined.

Honey comb appearance:the bone within the radiolucent area of destruction may take the form of strands which may intersect or produce honey comb appearance.

OSTEOBLASTIC

Margins-ill defined.

Sunray appearance:if the tumour has invaded the periostium,many thin irregular spicules of new bone directed outwards and perpendicular to the surface of the lesion are seen producing sunray appearance.

GRANULAR APPEARANCE

Scleortic portion of mixed and opaque lesion may show vertical obliteration of trabecular pattern by new bone,impairing dence granular appearance.

CODMAN’S TRIANGLE

Radioopacities project from the cortex and mark the lateral extremities of the lesion referred as codman’s triangle.its seen where the tumour breaks through the surface of the bone and it’s the result of seperation of the periostium from the surface of adjacent bone.

ONION PEEL APPEARANCE

Subperiosteal bone laid down in layers and it may

take form of onion peel lamination.

EWING’S SARCOMA

R/F:

Site:posterior area of mandible.

Margins:ill defined.

Sunray appearance:in advanced cases,where osteophyte formation is present,it may present as sunray appearance.

ONION PEEL APPEARANCE

If it penetrates the cortex,it may stimulate the periostium to produce thin layers.

Pathologic fracture-dest, of lamina dura and bone.

BURKITT’S LYMPHOMAIt is lyphoreticular cell malignancy.

B cell neoplasm.R/F:Sunray appearance-if periosteum is elevated,it will produce sunray appearance.

NEUROBLASTOMARare malignant tumor of the adrenal gland .It sometimes arises in the nerves or ganglia of the sympathetic system in the neck,thorac or abdomen.

MOTH EATEN APPEARANCESmall radiolucent foci scattered throughout the affected area.These small foci colaese and form amultilocular moth eaten appearance.

Margins ill defined.Balloon like expansion with thinning of adjacent structure.

R/FSunburst appearance-There are spicules of bone within the soft tissue mass associated with bone destruction,these are roughly perpendicular to the surface of the bone and resemble sun burst appearance.

SPOKE WHEEL APPEARANCE

Spicules of bone or trabeculae are arranged radially in a rough architecture of wheels or spokes.

Mottled area of calcification is seen in some cases.

Presented by: amandeep sharma prefinal year roll no:02