In evaluating lytic bone lesions, which statement is true?

In evaluating lytic bone lesions, which statement is true?

• A. Dexa scans are not indicated for lytic lesions
• B. Dexa scans are indicated for lytic lesions
• C. All lytic lesions are malignant
• D. Lytic lesions are due to infection only

Answer: (A)

Dexa bone density testing measures bone mineral density and is used to assess osteoporosis and fracture risk, not to evaluate the nature or extent of focal bone lesions. Because it doesn’t image lesion morphology or activity, it isn’t part of the work-up for lytic lesions. That’s why the statement that Dexa scans are not indicated for lytic lesions is true. When a lytic lesion is suspected, the work-up relies on imaging that shows the lesion’s appearance, borders, and activity. Plain radiographs can reveal the presence and pattern of lysis; CT helps define cortical destruction and matrix; MRI assesses marrow involvement and surrounding soft tissues; bone scans or PET-CT gauge metabolic activity and help survey for additional lesions. Biopsy may be needed if imaging is inconclusive or to establish a diagnosis. The other options aren’t correct because a lytic lesion is not automatically malignant, and it isn’t caused only by infection; there are benign tumors, cysts, healing lesions, metabolic processes, and other noninfectious causes that can produce lytic areas.

Dexa bone density testing measures bone mineral density and is used to assess osteoporosis and fracture risk, not to evaluate the nature or extent of focal bone lesions. Because it doesn’t image lesion morphology or activity, it isn’t part of the work-up for lytic lesions. That’s why the statement that Dexa scans are not indicated for lytic lesions is true.

When a lytic lesion is suspected, the work-up relies on imaging that shows the lesion’s appearance, borders, and activity. Plain radiographs can reveal the presence and pattern of lysis; CT helps define cortical destruction and matrix; MRI assesses marrow involvement and surrounding soft tissues; bone scans or PET-CT gauge metabolic activity and help survey for additional lesions. Biopsy may be needed if imaging is inconclusive or to establish a diagnosis.

The other options aren’t correct because a lytic lesion is not automatically malignant, and it isn’t caused only by infection; there are benign tumors, cysts, healing lesions, metabolic processes, and other noninfectious causes that can produce lytic areas.