title: Posttreatment imaging of pediatric musculoskeletal tumors.
abstract: Pediatric patients who are diagnosed with musculoskeletal tumors often require serial imaging both during and after treatment. Although many of the treatments used in adults overlap with those used in children and adolescents, the growing skeleton presents specific challenges that require a unique approach. Surgical treatment of benign osseous lesions typically requires only curettage and bone grafting, whereas that of osseous malignancies generally consists of wide excision and limb salvage, with either endoprosthetic or biologic reconstruction. Current conventional endoprostheses consist of modular components that allow intraoperative customization; however, if there is great potential for future growth, an expandable endoprosthesis may be required. Biologic reconstruction may consist of an allograft and/or autograft and, in some circumstances, can spare the growth plates in a child, thereby allowing normal growth. Expected posttreatment imaging findings in soft-tissue tumors may include muscle flaps and postoperative fluid collections. Medical treatment, including radiation therapy and chemotherapy, can have predictable imaging manifestations, including signal alterations in bone marrow, muscle, and subcutaneous fat. Finally, treatment complications may manifest with clinical symptoms and include infection or mechanical failure, although other complications such as local tumor recurrence may go clinically undetected until surveillance imaging. Familiarity with the expected posttreatment imaging findings in pediatric patients with musculoskeletal tumors can aid in the detection of complications.
authors.affiliation: From the Division of Pediatric Radiology (A.M.Z.) and Department of Orthopedic Surgery (J.I.S.), Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, MLC 5031, Cincinnati, OH 45229.
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Zbojniewicz
authors.forename: Joel I
authors.initials: JI
authors.lastname: Sorger
mesh_terms: D000359:Aftercare / Q000379:methods*; D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy; D016025:Bone Transplantation; D059248:Chemoradiotherapy; D002648:Child; D003131:Combined Modality Therapy; D006801:Humans; D023821:Limb Salvage; D064847:Multimodal Imaging; D019042:Muscle Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging; D009381:Neoplasms, Radiation-Induced / Q000000981:diagnostic imaging / Q000209:etiology; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011475:Prosthesis Failure; D011859:Radiography; D012983:Soft Tissue Neoplasms / Q000000981:diagnostic imaging / Q000628:therapy