What is the role of skeletal radiograph survey in the workup of Langerhans cell histiocytosis (LCH)?

Updated: Jun 12, 2020
  • Author: Christopher R Shea, MD; Chief Editor: William D James, MD  more...
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Unifocal LCH presents as a single osteolytic lesion, usually affecting long or flat bones (in children, the calvaria and femurs; in adults, the ribs).

Multifocal LCH shows osteolytic lesions involving the calvaria, sella turcica, mandible, vertebrae, and/or long bones of the upper extremities.

Note the image below.

On a plain skull radiograph, lesions are typically On a plain skull radiograph, lesions are typically lytic, with sharp borders and a punched out appearance.

Although radionuclide bone scanning is suggested for establishing the extent of osseous involvement, the latter is not as sensitive as the skeletal radiograph survey in most patients.

MRI of the head and spine is also useful to identify craniofacial or vertebral bone lesions.

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