<![CDATA[Bone and Soft Tissue Neoplasms]]>https://www.bstneoplasms.comhttps://substackcdn.com/image/fetch/$s_!LzdO!,w_256,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2Fd6bd471b-f449-4994-a7ca-020df9f523ff_947x947.pngBone and Soft Tissue Neoplasmshttps://www.bstneoplasms.comSubstackWed, 13 May 2026 09:56:25 GMT<![CDATA[Case 65: Mono-articular Knee Arthropathy]]>https://www.bstneoplasms.com/p/case65https://www.bstneoplasms.com/p/case65Mon, 11 May 2026 00:50:57 GMT

Please subscribe, if you would like to know each time a new post is published

Case:

48 years old had progressive knee pain.

Radiograph (Fig. 1) shows large articular margin erosions (arrows) along the peripheral margins with mild periarticular osteopenia.

Fig. 1

The T2 sagittal image (Fig. 2) shows large synovial nodules (arrows), T2 dark with an enlarged popliteal node (red arrow).

Fig. 2

The PD fat sat coronal image (FIg. 3) shows marrow edema with free margin erosions and large central erosions (arrows).

Fig. 3

The erosions (arrows) are much better appreciated on the T1 coronal image (Fig. 4).

Fig. 4

This is a mono-articular arthropathy. While tenosynovial giant cell tumor (see case below) may occur with T2 dark large intra-articular nodules, they rarely produce free edge erosions and marrow edema.

A mono-articular arthopathy should be assumed to be infective unless proven otherwise and this pattern is commonly seen with tuberculosis.

A biopsy confirmed the diagnosis.

This case also shows Phemister’s triad.

Other Tuberculosis Cases

Thanks for reading Bone and Soft Tissue Neoplasms! This post is public so feel free to share it.

Share

Index and Table of Contents

Previous Post

Content So Far

  • 65 Cases

  • 16 Cases of the Day

  • 5 Lectures

]]><![CDATA[April 2026 Digest]]>https://www.bstneoplasms.com/p/april-2026-digesthttps://www.bstneoplasms.com/p/april-2026-digestSat, 09 May 2026 07:28:01 GMTContent

We now have the following content

64 Cases

16 Cases of the Day

5 Lectures

Index and Table of Contents

This lists all the Cases since inception

Apr 2026

04 Apr

06 Apr

13 Apr

20 Apr

28 Apr

Share

Thanks for reading Bone and Soft Tissue Neoplasms! Subscribe for free to receive new posts and support my work.

Thanks for reading Bone and Soft Tissue Neoplasms! This post is public so feel free to share it.

Share

Share Bone and Soft Tissue Neoplasms

]]><![CDATA[Case 64: The Foggy Pattern of Myositis]]>https://www.bstneoplasms.com/p/case64https://www.bstneoplasms.com/p/case64Mon, 04 May 2026 01:07:26 GMT

Please subscribe, if you would like to know each time a new post is published

Case:

62-years old lady with inflammatory arthritis and auto-immune hepatitis came with muscle pain

Bilateral asymmetric edema without significant atrophy and fat infiltration
All the limbs and the girdles were involved

What is striking is the foggy pattern.

The video describes the classic foggy pattern and its implications

The Myositis Series

Thanks for reading Bone and Soft Tissue Neoplasms! This post is public so feel free to share it.

Share

Index and Table of Contents

Previous Post

]]><![CDATA[Case 63: The Honeycomb Pattern of Myositis]]>https://www.bstneoplasms.com/p/case63https://www.bstneoplasms.com/p/case63Tue, 28 Apr 2026 00:24:57 GMT

Please subscribe, if you would like to know each time a new post is published

Case:

61-yrs old with recent diagnosis of a myopathy.

Diffuse symmetric involvement of hamstrings and rectus femoris with edema and fat infiltration and atrophy

What is striking is the honeycomb pattern

The video describes the classic honeycomb pattern in this patient’s muscles and the implications and compares with the other patterns - fascial and peripheral/foggy described earlier in previous videos.

Earlier Myositis Videos

Thanks for reading Bone and Soft Tissue Neoplasms! This post is public so feel free to share it.

Share

Other Muscle Lesions

Index and Table of Contents

Previous Post

]]><![CDATA[Mar 2026 Digest]]>https://www.bstneoplasms.com/p/mar-2026-digesthttps://www.bstneoplasms.com/p/mar-2026-digestWed, 22 Apr 2026 08:58:37 GMTContent

We now have the following content

62 Cases

16 Cases of the Day

5 Lectures

Thanks for reading Bone and Soft Tissue Neoplasms! Subscribe for free to receive new posts and support my work.

Mar 2026

02 Mar

09 Mar

16 Mar

23 Mar

Thanks for reading Bone and Soft Tissue Neoplasms! This post is public so feel free to share it.

Share

Share Bone and Soft Tissue Neoplasms

]]><![CDATA[Case 62: The Symmetric Fascial Edema Pattern of Dermatomyositis]]>https://www.bstneoplasms.com/p/case62https://www.bstneoplasms.com/p/case62Mon, 20 Apr 2026 01:05:15 GMT

Please subscribe, if you would like to know each time a new post is published

Case:

35-years old man with dermatomyositis and limb pain on treatment came for a baseline myositis protocol MRI, which showed symmetric fascial edema as depicted in the images below.

Symmetric fascial edema thighs and legs - posterior compartment of thigh most involved
Symmetric fascial edema arms, with subtle muscle edema triceps

The video (published earlier as COD 053) discusses the case, the myositis protocol MRI and the various patterns of muscle involvement in different forms of myositis.

Thanks for reading Bone and Soft Tissue Neoplasms! This post is public so feel free to share it.

Share

Other Muscle Lesions

Index and Table of Contents

Previous Post

]]><![CDATA[Case 61: Dermatomyositis and the Myositis Protocol MRI]]>https://www.bstneoplasms.com/p/case61https://www.bstneoplasms.com/p/case61Mon, 13 Apr 2026 00:18:44 GMT

Please subscribe, if you would like to know each time a new post is published

Case:

55-years old diagnosed to have dermatomyositis, referred for a myositis protocol MRI.

Right upper limb - no edema, marked atrophy
Left upper limb - no edema, marked atrophy
Pelvis - mild edema, marked atrophy
Thighs - no edema, marked atrophy

The video (published earlier as COD 021) discusses the case, the myositis protocol MRI and other cases of dermatomyositis.

This site will also include cases of diffuse myositis and myopathies.

Thanks for reading Bone and Soft Tissue Neoplasms! This post is public so feel free to share it.

Share

Other Muscle Lesions

Index and Table of Contents

Previous Post

]]><![CDATA[Case 60: The Pitfalls of Rib Uptake on PSMA PET]]>https://www.bstneoplasms.com/p/case60https://www.bstneoplasms.com/p/case60Sun, 05 Apr 2026 23:57:02 GMT

Please subscribe, if you would like to know each time a new post is published

Case:

63-years old with Ca prostate had uptake on PSMA in the left 3rd rib anteriorly and right 6th rib posteriorly. The CT does not show any lesion there (Fig. 1).

A repeat FDG PET done 2 weeks later shows no uptake in those areas and no morphologic rib lesion (Fig. 2).

This is a known pitfall with PSMA PET for some reason. Isolated benign rib uptake without disease.

One paper (Fig. 3) has these statistics - 52% of biopsy-negative lesions were in the rib and only 26% of all rib biopsies performed for metastatic cancer were positive in patients who had PSMA positive rib uptake.

Takeaway - isolated rib uptake on PSMA PET should be viewed with caution and should not be automatically assumed to be metastatic disease. These lesions should be worked up carefully assuming they are benign unless proven otherwise.

Thanks for reading Bone and Soft Tissue Neoplasms! This post is public so feel free to share it.

Share

Other Rib Lesions

Index and Table of Contents

Previous Post

]]><![CDATA[Case 59: Spina Ventosa is More than Just Dactylitis]]>https://www.bstneoplasms.com/p/case59https://www.bstneoplasms.com/p/case59Sat, 04 Apr 2026 02:53:56 GMT

Please subscribe, if you would like to know each time a new post is published

Case:

11-years old with sternal and neck swelling

MRI showed an expansile osteolytic lesion in the manubrium sternum.

There were also enlarged left supraclavicular and mediastinal nodes.

The patient was referred for a CT guided biopsy. On CT, the lesion had a “bone-in-bone” appearance.

The video describes the case, the “ballooned-out” manubrium, the concept of spina ventosa, pictures from the 18th century showing spina ventosa in different bones of the body including the craniofacial skeleton and images of different bones show spina ventosa.

In short, “spina ventosa”, though synonymous with tuberculous dactylitis in current times, can actually affect any bone in the body...phalanges and metacarpals and metatarsals are just the more commonly involved bones.

Full Video


Thanks for reading Bone and Soft Tissue Neoplasms! This post is public so feel free to share it.

Share

Index and Table of Contents

Previous Post

]]><![CDATA[Case 58: A Milwaukee Shoulder in Mumbai]]>https://www.bstneoplasms.com/p/case58https://www.bstneoplasms.com/p/case58Mon, 23 Mar 2026 13:08:45 GMT

Please subscribe, if you would like to know each time a new post is published

Case:

66-years old man with gradually progressive pain, without fever in the right shoulder.

MRI showed a destructive arthropathy, as did a CT scan. Neuroarthropathy was ruled out with an MRI cervical spine.

The video describes the findings and the final diagnosis obtained on USG guided aspiration.

Full Video

Thanks for reading Bone and Soft Tissue Neoplasms! This post is public so feel free to share it.

Share

Index and Table of Contents

Previous Post

]]><![CDATA[Case 57: Hemosiderin Blooming]]>https://www.bstneoplasms.com/p/case57https://www.bstneoplasms.com/p/case57Mon, 16 Mar 2026 01:14:52 GMT

Please subscribe, if you would like to know each time a new post is published

Case:

23-years old known to have tenosynovial giant cell tumor - the gradient image (lower left image) shows blooming of hemosiderin (green arrows).

The nodular synovitis is T2 dark in the sagittal and axial images. This used to be earlier called pigmented villonodular synovitis (PVNS).

To know more about the tumor.

Thanks for reading Bone and Soft Tissue Neoplasms! This post is public so feel free to share it.

Share

Index and Table of Contents

Previous Post

]]><![CDATA[Case 56: A Benign Aggressive Tibial Lesion]]>https://www.bstneoplasms.com/p/case56https://www.bstneoplasms.com/p/case56Mon, 09 Mar 2026 00:41:18 GMT

Please subscribe, if you would like to know each time a new post is published

Case:

25-years old with knee pain.

X-ray shows an osteolytic lesion with a sclerotic rim - this is a benign lesion.

MRI shows marrow edema - this is now a “benign aggressive” lesion.

The lesion is partly T2 dark and shows a lamellated pattern of enhancement and is eccentric juxtamedullary.

A biopsy was done.

The findings are characteristic of chondromyxoid fibroma.

To know more about the tumor.

Thanks for reading Bone and Soft Tissue Neoplasms! This post is public so feel free to share it.

Share

Index and Table of Contents

Previous Post

]]><![CDATA[COD 180 - Sequestrum, Involucrum, Cloaca]]>https://www.bstneoplasms.com/p/cod180https://www.bstneoplasms.com/p/cod180Sun, 01 Mar 2026 23:52:02 GMT

Please subscribe, if you would like to know each time a new post is published

Case:

26-years old presented with progressive pain in the left thigh and fever.

The first MRI showed marrow edema with mild periosseous edema and no other pathology. The radiograph 16 days later showed permeative cortical involvement and then a PET was done followed by a CT scan and CT guided biopsy.

The video discusses the case and shows the rapid progressive of disease in 24 days and the evolution of a sequestrum, involucrum and cloaca.

The final diagnosis was Staphylococcus aureus hematogenous osteomyelitis of the femur.

Thanks for reading Bone and Soft Tissue Neoplasms! Subscribe for free to receive new posts and support my work.

Video

Thanks for reading Bone and Soft Tissue Neoplasms! This post is public so feel free to share it.

Share

Index and Table of Contents

Previous Case of the Day Posts

Previous Similar Post

]]><![CDATA[COD 178 - Webspace Tear-Drops and Slugs]]>https://www.bstneoplasms.com/p/cod178https://www.bstneoplasms.com/p/cod178Wed, 25 Feb 2026 13:48:10 GMT

Please subscribe, if you would like to know each time a new post is published

Case:

37-years old with plantar forefoot pain.

MRI was done.

The video discusses the case, the diagnosis of Morton neuroma, pitfalls, new signs including the “slug” sign and differentials.

Thanks for reading Bone and Soft Tissue Neoplasms! Subscribe for free to receive new posts and support my work.

Video

Thanks for reading Bone and Soft Tissue Neoplasms! This post is public so feel free to share it.

Share

Index and Table of Contents

Previous Case of the Day Posts

]]><![CDATA[COD 152 - Large Calcific-Ossific Rib Masses]]>https://www.bstneoplasms.com/p/cod152https://www.bstneoplasms.com/p/cod152Tue, 17 Feb 2026 14:18:40 GMT

Please subscribe, if you would like to know each time a new post is published

Case:

66-years old with old left Ca breast treated with surgery, chemo RT 25 years ago went for MRI shoulder, which showed rib lesions.

The video explains the case, and shows what those rib lesions were, related to the radiation given in 2000, superficially resembling “tumoral calcinosis” and “radiation sarcoma”.

Thanks for reading Bone and Soft Tissue Neoplasms! Subscribe for free to receive new posts and support my work.

Video

Thanks for reading Bone and Soft Tissue Neoplasms! This post is public so feel free to share it.

Share

Index and Table of Contents

Previous Case of the Day Posts

]]><![CDATA[COD 151 - The Enigmatic Calcaneal Lesion in Diard Area 6]]>https://www.bstneoplasms.com/p/cod151https://www.bstneoplasms.com/p/cod151Thu, 05 Feb 2026 00:44:23 GMT

Please subscribe, if you would like to know each time a new post is published

Case:

16-years old with an osteolytic lesion in this specific Diard 6 area of the calcaneum.

Is it cyst? lipoma? Does it matter? Are they perhaps part of the same continuum?

The video describes the case and revisits another case -

- to understand all these concepts and the possible etiology of these uniquely situated lesions.

Thanks for reading Bone and Soft Tissue Neoplasms! Subscribe for free to receive new posts and support my work.

Video

Thanks for reading Bone and Soft Tissue Neoplasms! This post is public so feel free to share it.

Share

Index and Table of Contents

Previous Case of the Day Posts

Previous Similar Case

]]><![CDATA[COD 148 - A Rib Lesion with Uptake on PET]]>https://www.bstneoplasms.com/p/cod148https://www.bstneoplasms.com/p/cod148Thu, 22 Jan 2026 14:17:04 GMT

Please subscribe, if you would like to know each time a new post is published

Case:

44-years old with fever and a PET showing an osteolytic lesion with uptake in the left 7th rib.

The video describes the case and discusses the possibilities and arrives at a diagnosis.

Video

Thanks for reading Bone and Soft Tissue Neoplasms! This post is public so feel free to share it.

Share

Index and Table of Contents

Previous Case of the Day Posts

Previous Similar Case

]]><![CDATA[COD 145 - A Swollen Face and The Tincture of Time]]>https://www.bstneoplasms.com/p/cod145https://www.bstneoplasms.com/p/cod145Sun, 11 Jan 2026 01:18:20 GMT

Please subscribe, if you would like to know each time a new post is published

Case:

3 months old in Jul 2023 with diffuse facial swelling due to mandibular periosteal reaction and masseter edema.

A diagnosis was made and the patient disappeared and came back yesterday for follow-up.

The video discusses the diagnosis and its relationship to chronic nonbacterial osteitis (CNO) which was discussed as Case 136.

Video

Thanks for reading Bone and Soft Tissue Neoplasms! This post is public so feel free to share it.

Share

Index and Table of Contents

Previous Case of the Day Posts

Previous Similar Case

]]><![CDATA[COD 140 - Spontaneous Epidural Hematoma Resolving Spontaneously ]]>https://www.bstneoplasms.com/p/cod140https://www.bstneoplasms.com/p/cod140Fri, 02 Jan 2026 01:03:57 GMT

Please subscribe, if you would like to know each time a new post is published

Case:

6-years old boy with acute upper thoracic pain and intermittent fever. MRI showed a posterior epidural collection from D3 to D6 extending into the right 3rd intercostal space.

The patient was referred for a biopsy.

The video explains what happened and discusses the diagnosis with another similar case in a 60-years old.

Video

Thanks for reading Bone and Soft Tissue Neoplasms! This post is public so feel free to share it.

Share

Index and Table of Contents

Previous Case of the Day Posts

Previous Similar Case

]]><![CDATA[COD 146 - The T2 Dark Retro-Odontoid Soft Tissue ]]>https://www.bstneoplasms.com/p/cod146https://www.bstneoplasms.com/p/cod146Thu, 25 Dec 2025 07:28:56 GMT

Please subscribe, if you would like to know each time a new post is published

Case:

91-years old referred for a CT guided biopsy.

MRI showed a T2 dark retro-odontoid soft tissue lesion.

Was this infection? Tuberculosis? Pannus? Neoplasm? Pseudotumor?

The video describes the case, the diagnosis, the etiology and 3 other cases

Video

Thanks for reading Bone and Soft Tissue Neoplasms! This post is public so feel free to share it.

Share

Index and Table of Contents

Previous Case of the Day Posts

Previous Similar Case

]]>