• Blade of grass: V-shaped lucency in metadiaphysis, usually in long bone, representing lytic phase
  • Most often seen in femur and tibia
  • In skull, lytic defect = osteoporosis circumscripta, most often seen in the frontal bone
  • Findings

–Lytic, mixed, sclerotic phases

–Coarsened trabeculae, cortical thickening

–Lytic phase almost always hot on bone scan

  • Complications: bowing, fx, sarcomatous degeneration (rare)

Ivory Vertebra

DDx

–Blastic mets (prostate, breast)

–Infection (TB)

–Lymphoma

–Paget disease