Oliver T B, Bhat R, Kellett C F, Adamson D J
Department of Clinical Radiology, Ninewells Hospital, Dundee, DD1 9SY, UK.
J R Coll Physicians Edinb. 2011 Dec;41(4):330-8. doi: 10.4997/JRCPE.2011.410.
Bone metastases are a common feature of many cancers and patients with a previous history of cancer may present with bony symptoms to many different specialties. It is, however, easy to mistakenly diagnose secondary bone cancer in patients who have abnormal imaging, when the cause of the symptoms and the abnormal imaging results is benign disease. In this review, common diagnostic mistakes are described with examples of imaging of both benign and malignant bony disease. The relative risk of developing bone metastases in different cancers is discussed, as well as the rationale of different therapies for proven bony metastases, such as radiotherapy, bisphosphonate therapy, orthopaedic intervention and vertebroplasty.
骨转移是许多癌症的常见特征，有癌症病史的患者可能会因骨相关症状就诊于多个不同专科。然而，对于影像学检查异常的患者，当症状和影像学异常结果的原因是良性疾病时，很容易误诊为继发性骨癌。在这篇综述中，通过良性和恶性骨病的影像学实例描述了常见的诊断错误。讨论了不同癌症发生骨转移的相对风险，以及针对已证实的骨转移采用不同治疗方法（如放疗、双膦酸盐治疗、骨科干预和椎体成形术）的基本原理。
