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Current Medical Imaging

Editor-in-Chief

ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

Review Article

Fluid-fluid Levels in Musculoskeletal Tumor Imaging

Author(s): Shinji Tsukamoto, Costantino Errani*, Fabio Facchini, Panayiotis Papagelopoulos and Andreas F. Mavrogenis

Volume 17 , Issue 2 , 2021

Published on: 06 August, 2020

Page: [157 - 165] Pages: 9

DOI: 10.2174/1573405616666200806173258

Price: $65

Abstract

Fluid-fluid levels result from the separation of two fluids of differing densities within a cavernous space with the boundary between the two layers running in a horizontal plane at 90 degrees to the direction of gravity. Magnetic resonance imaging is the most sensitive imaging modality to identify fluid-fluid levels. Although the most common bone lesions containing fluid-fluid levels are aneurysmal bone cyst and telangiectatic osteosarcoma, fluid-fluid levels can be observed in a wide variety of bone and soft tissue lesions. Therefore, fluid-fluid levels cannot be considered diagnostic of any particular type of tumor and the diagnosis should be made on the basis of other clinical, radiological and pathological findings. This article summarizes the pathophysiology and imaging characteristics of fluid-fluid levels and discusses the differential diagnosis of tumors with this imaging sign.

Keywords: Fluid-fluid levels, imaging, differential diagnosis, bone tumors, soft tissue tumors, prognosis.

Graphical Abstract
[1]
Tsai JC, Dalinka MK, Fallon MD, Zlatkin MB, Kressel HY. Fluid-fluid level: A nonspecific finding in tumors of bone and soft tissue. Radiology 1990; 175(3): 779-82.
[http://dx.doi.org/10.1148/radiology.175.3.2160676] [PMID: 2160676]
[2]
Van Dyck P, Vanhoenacker FM, Vogel J, et al. Prevalence, extension and characteristics of fluid-fluid levels in bone and soft tissue tumors. Eur Radiol 2006; 16(12): 2644-51.
[http://dx.doi.org/10.1007/s00330-006-0250-1] [PMID: 16612549]
[3]
Ehara S, Sone M, Tamakawa Y, Nishida J, Abe M, Hachiya J. Fluid-fluid levels in cavernous hemangioma of soft tissue. Skeletal Radiol 1994; 23(2): 107-9.
[http://dx.doi.org/10.1007/BF00563202] [PMID: 8191292]
[4]
Saifuddin A, Burnett SJ, Mitchell R. Pictorial review: Ultrasonography of primary bone tumours. Clin Radiol 1998; 53(4): 239-46.
[http://dx.doi.org/10.1016/S0009-9260(98)80119-0] [PMID: 9585036]
[5]
Hudson TM. Fluid levels in aneurysmal bone cysts: A CT feature. AJR Am J Roentgenol 1984; 142(5): 1001-4.
[http://dx.doi.org/10.2214/ajr.142.5.1001] [PMID: 6609547]
[6]
Burr BA, Resnick D, Syklawer R, Haghighi P. Fluid-fluid levels in a unicameral bone cyst: CT and MR findings. J Comput Assist Tomogr 1993; 17(1): 134-6.
[http://dx.doi.org/10.1097/00004728-199301000-00025] [PMID: 8419422]
[7]
Rafii M, Firooznia H, Golimbu C, McCauley DI. Hematogenous osteomyelitis with fat-fluid level shown by CT. Radiology 1984; 153(2): 493-4.
[http://dx.doi.org/10.1148/radiology.153.2.6385108] [PMID: 6385108]
[8]
Davies AM, Cassar-Pullicino VN, Grimer RJ. The incidence and significance of fluid-fluid levels on computed tomography of osseous lesions. Br J Radiol 1992; 65(771): 193-8.
[http://dx.doi.org/10.1259/0007-1285-65-771-193] [PMID: 1547444]
[9]
Alyas F, Saifuddin A. Fluid-fluid levels in bone neoplasms: variation of T1-weighted signal intensity of the superior to inferior layers--diagnostic significance on magnetic resonance imaging. Eur Radiol 2008; 18(11): 2642-51.
[http://dx.doi.org/10.1007/s00330-008-1060-4] [PMID: 18546000]
[10]
O’Donnell P, Saifuddin A. The prevalence and diagnostic significance of fluid-fluid levels in focal lesions of bone. Skeletal Radiol 2004; 33(6): 330-6.
[http://dx.doi.org/10.1007/s00256-004-0779-5] [PMID: 15138727]
[11]
Keenan S, Bui-Mansfield LT. Musculoskeletal lesions with fluid-fluid level: A pictorial essay. J Comput Assist Tomogr 2006; 30(3): 517-24.
[http://dx.doi.org/10.1097/00004728-200605000-00029] [PMID: 16778633]
[12]
Yu H, Cui J-L, Cui S-J, Sun YC, Cui FZ. Differentiating benign from malignant bone tumors using fluid-fluid level features on magnetic resonance imaging. Korean J Radiol 2014; 15(6): 757-63.
[http://dx.doi.org/10.3348/kjr.2014.15.6.757] [PMID: 25469087]
[13]
Park C-K, Kim D-C, Park S-H, et al. Microhemorrhage, a possible mechanism for cyst formation in vestibular schwannomas. J Neurosurg 2006; 105(4): 576-80.
[http://dx.doi.org/10.3171/jns.2006.105.4.576] [PMID: 17044561]
[14]
Lu ZH, Wu M. Unusual features in an adult pancreatic hemangioma: CT and MRI demonstration. Korean J Radiol 2013; 14(5): 781-5.
[http://dx.doi.org/10.3348/kjr.2013.14.5.781] [PMID: 24043972]
[15]
Fu H, Hao S-Y, Jia G-J, Zhang JT, Zhang LW. A cystic vestibular schwannoma with a fluid-fluid level. Chin Med J (Engl) 2012; 125(21): 3920.
[PMID: 23106902]
[16]
Catalano P, Fang-Hui E, Som PM. Fluid-fluid levels in benign neurogenic tumors. AJNR Am J Neuroradiol 1997; 18(2): 385-7.
[PMID: 9111681]
[17]
Li W-C, Hong X-Y, Wang L-P, Ge PF, Fu SL, Luo YN. Large cystic hypoglossal schwannoma with fluid-fluid level: A case report. Skull Base 2010; 20(3): 193-7.
[http://dx.doi.org/10.1055/s-0029-1246219] [PMID: 21318038]
[18]
Chin KF, Babar J, Tzifa K, Chavda SV, Irving RM. Vestibular schwannomas with fluid-fluid level. J Laryngol Otol 2007; 121(9): 902-6.
[http://dx.doi.org/10.1017/S002221510700638X] [PMID: 17320004]
[19]
Chang W-C, Huang G-S, Lee H-S, Lee CH, Hsu YC. Fluid-fluid level in peripheral nerve schwannoma: Report of a case with histological correlation. Clin Imaging 2009; 33(3): 248-51.
[http://dx.doi.org/10.1016/j.clinimag.2008.11.001] [PMID: 19411036]
[20]
Gomori JM, Grossman RI. Mechanisms responsible for the MR appearance and evolution of intracranial hemorrhage. Radiographics 1988; 8(3): 427-40.
[http://dx.doi.org/10.1148/radiographics.8.3.3380989] [PMID: 3380989]
[21]
Jones BC, Sundaram M, Kransdorf MJ. Synovial sarcoma: MR imaging findings in 34 patients. Am J Roentgenol 1993; 161(4): 827-30.
[http://dx.doi.org/10.2214/ajr.161.4.8396848] [PMID: 8396848]
[22]
Alyas F, James SL, Davies AM, Saifuddin A. The role of MR imaging in the diagnostic characterisation of appendicular bone tumours and tumour-like conditions. Eur Radiol 2007; 17(10): 2675-86.
[http://dx.doi.org/10.1007/s00330-007-0597-y] [PMID: 17342487]
[23]
Takemura N, Fujii N, Shibata C, et al. Fluid-fluid level in a giant epidermal cyst of the buttock. J Dermatol 2007; 34(3): 193-7.
[http://dx.doi.org/10.1111/j.1346-8138.2007.00248.x] [PMID: 17291301]
[24]
Fisher AJ, Totty WG, Kyriakos M. MR appearance of cystic fibrous dysplasia. J Comput Assist Tomogr 1994; 18(2): 315-8.
[http://dx.doi.org/10.1097/00004728-199403000-00032] [PMID: 8126292]
[25]
Ishida T, Yamamoto M, Goto T, Kawano H, Yamamoto A, Machinami R. Clear cell chondrosarcoma of the pelvis in a skeletally immature patient. Skeletal Radiol 1999; 28(5): 290-3.
[http://dx.doi.org/10.1007/s002560050519] [PMID: 10424338]
[26]
Kahmann R, Gold RH, Eckardt JJ, Mirra JM. Case report 337: Cystic chondroblastoma of calcaneus. Skeletal Radiol 1985; 14(4): 301-4.
[http://dx.doi.org/10.1007/BF00352624] [PMID: 4071107]
[27]
Kaplan PA, Murphey M, Greenway G, Resnick D, Sartoris DJ, Harms S. Fluid-fluid levels in giant cell tumors of bone: report of two cases. J Comput Tomogr 1987; 11(2): 151-5.
[http://dx.doi.org/10.1016/0149-936X(87)90008-7] [PMID: 3581850]
[28]
Gutierrez LB, Link TM, Horvai AE, Joseph GB, O’Donnell RJ, Motamedi D. Secondary aneurysmal bone cysts and associated primary lesions: imaging features of 49 cases. Clin Imaging 2020; 62: 23-32.
[http://dx.doi.org/10.1016/j.clinimag.2020.01.022] [PMID: 32036238]
[29]
Jee WH, Choi KH, Choe BY, Park JM, Shinn KS. Fibrous dysplasia: MR imaging characteristics with radiopathologic correlation. Am J Roentgenol 1996; 167(6): 1523-7.
[http://dx.doi.org/10.2214/ajr.167.6.8956590] [PMID: 8956590]
[30]
Albadr FB, Elgamal EA, Alorainy IA, Hassan HH. Fluid-fluid level in Langerhans cell histiocytosis of the skull. Neurosciences (Riyadh) 2006; 11(1): 47-9.
[PMID: 22266503]
[31]
Pennekamp W, Peters S, Schinkel C, et al. Aneurysmal bone cyst of the cervical spine. Eur Radiol 2008; 18(10): 2356-60.
[http://dx.doi.org/10.1007/s00330-008-0944-7] [PMID: 18784950]
[32]
Krishna Varanasi VR, Leong MY, Tan AM, Derrick Lian WQ, Teo ELHJ. Langerhans cell histiocytosis: Another cause of a fluid-fluid level within an appendicular bony lesion. BJR Case Rep 2016; 2(1): 20150408.
[http://dx.doi.org/10.1259/bjrcr.20150408] [PMID: 30364434]
[33]
Matsushita K, Shimono T, Miki Y. Langerhans cell histiocytosis with multiple fluid-fluid levels in the parietal bone. Magn Reson Med Sci 2020; 19(1): 5-6.
[http://dx.doi.org/10.2463/mrms.ci.2018-0152] [PMID: 30828044]
[34]
Nguyen BD, Westra WH, Kuhlman JE. Bone metastasis from breast carcinoma with fluid-fluid level. Skeletal Radiol 1996; 25(2): 189-92.
[http://dx.doi.org/10.1007/s002560050061] [PMID: 8848754]
[35]
Zishan US, Pressney I, Khoo M, Saifuddin A. The differentiation between aneurysmal bone cyst and telangiectatic osteosarcoma: a clinical, radiographic and MRI study. Skeletal Radiol 2020.
[http://dx.doi.org/10.1007/s00256-020-03432-w] [PMID: 32248448]
[36]
Yin J-Q, Fu Y-W, Xie X-B, et al. Telangiectatic osteosarcoma: Outcome analyses and a diagnostic model for differentiation from aneurysmal bone cyst. J Bone Oncol 2017; 11: 10-6.
[http://dx.doi.org/10.1016/j.jbo.2017.11.003] [PMID: 29892520]
[37]
Tillman BP, Dahlin DC, Lipscomb PR, Stewart JR. Aneurysmal bone cyst: an analysis of ninety-five cases. Mayo Clin Proc 1968; 43(7): 478-95.
[PMID: 5710584]
[38]
Ruiter DJ, van Rijssel TG, van der Velde EA. Aneurysmal bone cysts: a clinicopathological study of 105 cases. Cancer 1977; 39(5): 2231-9.
[http://dx.doi.org/10.1002/1097-0142(197705)39:5<2231::AID-CNCR2820390541>3.0.CO;2-Q] [PMID: 265751]
[39]
Murphey MD, wan Jaovisidha S, Temple HT, Gannon FH, Jelinek JS, Malawer MM. Telangiectatic osteosarcoma: radiologic-pathologic comparison. Radiology 2003; 229(2): 545-53.
[http://dx.doi.org/10.1148/radiol.2292021130] [PMID: 14512511]
[40]
Oliveira AM, Perez-Atayde AR, Inwards CY, et al. USP6 and CDH11 oncogenes identify the neoplastic cell in primary aneurysmal bone cysts and are absent in so-called secondary aneurysmal bone cysts. Am J Pathol 2004; 165(5): 1773-80.
[http://dx.doi.org/10.1016/S0002-9440(10)63432-3] [PMID: 15509545]
[41]
Davila JA, Amrami KK, Sundaram M, Adkins MC, Unni KK. Chondroblastoma of the hands and feet. Skeletal Radiol 2004; 33(10): 582-7.
[http://dx.doi.org/10.1007/s00256-004-0762-1] [PMID: 15316680]
[42]
Margau R, Babyn P, Cole W, Smith C, Lee F. MR imaging of simple bone cysts in children: Not so simple. Pediatr Radiol 2000; 30(8): 551-7.
[http://dx.doi.org/10.1007/s002470000258] [PMID: 10993540]
[43]
Hudson TM, Hamlin DJ, Fitzsimmons JR. Magnetic resonance imaging of fluid levels in an aneurysmal bone cyst and in anticoagulated human blood. Skeletal Radiol 1985; 13(4): 267-70.
[http://dx.doi.org/10.1007/BF00355347] [PMID: 4001968]
[44]
Kransdorf MJ, Utz JA, Gilkey FW, Berrey BH. MR appearance of fibroxanthoma. J Comput Assist Tomogr 1988; 12(4): 612-5.
[http://dx.doi.org/10.1097/00004728-198807000-00014] [PMID: 3392262]
[45]
Lum PA, Davis MJ, Orizaga M. Computed tomography fluid-fluid level in bone metastasis. Can Assoc Radiol J 1990; 41(5): 296-9.
[PMID: 2169972]
[46]
Propeck T, Bullard MA, Lin J, Doi K, Martel W. Radiologic -pathologic correlation of intraosseous lipomas. AJR Am J Roentgenol 2000; 175(3): 673-8.
[http://dx.doi.org/10.2214/ajr.175.3.1750673] [PMID: 10954449]
[47]
Nabavizadeh SA, Bilaniuk LT, Feygin T, Shekdar KV, Zimmerman RA, Vossough A. CT and MRI of pediatric skull lesions with fluid-fluid levels. AJNR Am J Neuroradiol 2014; 35(3): 604-8.
[http://dx.doi.org/10.3174/ajnr.A3712] [PMID: 23969345]
[48]
Kanazawa M, Nishimaki K, Koide T, et al. A case of cystic cavernous angioma accompanied by a fluid-fluid level on magnetic resonance imaging. No To Shinkei 2004; 56(8): 695-9.
[PMID: 15508738]
[49]
Vilanova JC, Dolz JL, Maestro de Leon JL, Aparicio A, Aldomà J, Capdevila A. MR imaging of a malignant schwannoma and an osteoblastoma with fluid-fluid levels. Report of two new cases. Eur Radiol 1998; 8(8): 1359-62.
[http://dx.doi.org/10.1007/s003300050552] [PMID: 9853214]
[50]
Wang XL, Gielen JL, Salgado R, Delrue F, De Schepper AM. Soft tissue aneurysmal bone cyst. Skeletal Radiol 2004; 33(8): 477-80.
[http://dx.doi.org/10.1007/s00256-004-0748-z] [PMID: 15150676]
[51]
Kato H, Kanematsu M, Mizuta K, et al. Fluid-fluid level formation: a rare finding of extracranial head and neck schwannomas. AJNR Am J Neuroradiol 2009; 30(7): 1451-3.
[http://dx.doi.org/10.3174/ajnr.A1511] [PMID: 19279278]
[52]
Goel A, Shah A, Jhawar SS, Goel NK. Fluid-fluid level in pituitary tumors: analysis of management of 106 cases. J Neurosurg 2010; 112(6): 1341-6.
[http://dx.doi.org/10.3171/2009.11.JNS091083] [PMID: 19961310]
[53]
Jhawar SS, Mahore A, Goel A. Intramedullary spinal neurenteric cyst with fluid-fluid level. J Neurosurg Pediatr 2012; 9(5): 542-5.
[http://dx.doi.org/10.3171/2012.1.PEDS11469] [PMID: 22546033]
[54]
Li P, Bi Z, Hao S, Zhang J. Multicystic vestibular schwannomas with fluid-fluid levels: A report of three cases. Oncol Lett 2015; 10(1): 206-10.
[http://dx.doi.org/10.3892/ol.2015.3211] [PMID: 26171000]
[55]
DiNardo LJ, Mellis MG. Cystic schwannoma of the sphenoid sinus and skull base. Ear Nose Throat J 1993; 72(12): 816-8.
[http://dx.doi.org/10.1177/014556139307201212] [PMID: 8313867]
[56]
Kawamura Y, Sze G. Totally cystic schwannoma of the tenth cranial nerve mimicking an epidermoid. AJNR Am J Neuroradiol 1992; 13(5): 1333-4.
[PMID: 1414824]
[57]
Sigal R, d’Anthouard F, David P, et al. Cystic schwannoma mimicking a brain stem tumor: MR features. J Comput Assist Tomogr 1990; 14(4): 662-4.
[http://dx.doi.org/10.1097/00004728-199007000-00030] [PMID: 2370366]
[58]
Schultz E, Sapan MR, McHeffey-Atkinson B, Naidich JB, Arlen M. Case report 872. “Ancient” schwannoma (degenerated neurilemoma). Skeletal Radiol 1994; 23(7): 593-5.
[http://dx.doi.org/10.1007/bf00223102] [PMID: 7824996]
[59]
Charabi S, Mantoni M, Tos M, Thomsen J. Cystic vestibular schwannomas: neuroimaging and growth rate. J Laryngol Otol 1994; 108(5): 375-9.
[http://dx.doi.org/10.1017/S0022215100126854] [PMID: 8035113]
[60]
Tali ET, Yuh WT, Nguyen HD, et al. Cystic acoustic schwannomas: MR characteristics. AJNR Am J Neuroradiol 1993; 14(5): 1241-7.
[PMID: 8237710]
[61]
Lidov M, Som PM, Stacy C, Catalano P. Eccentric cystic facial schwannoma: CT and MR features. J Comput Assist Tomogr 1991; 15(6): 1065-7.
[http://dx.doi.org/10.1097/00004728-199111000-00036] [PMID: 1939762]
[62]
Morrissey MS, Sellars SL. Vagal nerve schwannoma-a new diagnostic sign. Postgrad Med J 1990; 66(771): 42-3.
[http://dx.doi.org/10.1136/pgmj.66.771.42] [PMID: 2349165]
[63]
Faucett DC, Dutton JJ, Bullard DE. Gasserian ganglion schwannoma with orbital extension. Ophthal Plast Reconstr Surg 1989; 5(4): 235-8.
[http://dx.doi.org/10.1097/00002341-198912000-00002] [PMID: 2487229]
[64]
Nakanishi H, Araki N, Sawai Y, et al. Cystic synovial sarcomas: imaging features with clinical and histopathologic correlation. Skeletal Radiol 2003; 32(12): 701-7.
[http://dx.doi.org/10.1007/s00256-003-0690-5] [PMID: 14564484]
[65]
Kale HA, Rathod KR, Prasad SR, Madiwale CM, Sheth RJ. Mandibular haemophilic pseudotumour containing a fluid-fluid level. Br J Radiol 2001; 74(878): 186-8.
[http://dx.doi.org/10.1259/bjr.74.878.740186] [PMID: 11718393]
[66]
Hatano H, Morita T, Kobayashi H, Ito T, Segawa H. MR imaging findings of an unusual case of myositis ossificans presenting as a progressive mass with features of fluid-fluid level. J Orthop Sci 2004; 9(4): 399-403.
[http://dx.doi.org/10.1007/s00776-004-0795-2] [PMID: 15278779]
[67]
Kransdorf MJ, Meis JM, Jelinek JS. Myositis ossificans: MR appearance with radiologic-pathologic correlation. AJR Am J Roentgenol 1991; 157(6): 1243-8.
[http://dx.doi.org/10.2214/ajr.157.6.1950874] [PMID: 1950874]
[68]
Yousefzadeh DK, Jackson JH. Lipohemarthrosis of the elbow joint. Radiology 1978; 128(3): 643-5.
[http://dx.doi.org/10.1148/128.3.643] [PMID: 674631]
[69]
Rafii M, Firooznia H, Golimbu C, Waugh T Jr, Naidich D. The impact of CT in clinical management of pelvic and acetabular fractures. Clin Orthop Relat Res 1983; (178): 228-35.
[http://dx.doi.org/10.1097/00003086-198309000-00031] [PMID: 6883856]
[70]
Maldjian C, Adam R, Bonakdarpour A, Robinson TM, Shienbaum AJ. MRI appearance of clear cell hidradenoma. Skeletal Radiol 1999; 28(2): 104-6.
[http://dx.doi.org/10.1007/s002560050483] [PMID: 10197457]
[71]
Arger PH, Oberkircher PE, Miller WT. Lipohemarthrosis. Am J Roentgenol Radium Ther Nucl Med 1974; 121(1): 97-100.
[http://dx.doi.org/10.2214/ajr.121.1.97] [PMID: 4833893]
[72]
Grey AC, Mangham DC, Davies AM, Grimer RJ. Fluid-fluid level in an intraosseous ganglion. Skeletal Radiol 1997; 26(11): 667-70.
[http://dx.doi.org/10.1007/s002560050308] [PMID: 9428076]
[73]
Sarliève P, Lerais JM, Delabrousse E, Clair C, Kastler B, Krause D. [Fluid-fluid level in an intra-osseous ganglion cyst of the talus]. J Radiol 2003; 84(4 Pt 1): 417-9.
[PMID: 12759659]
[74]
Menges V, Prager P, Cserhati MD, Becker W, Griss P, Wurster K. Intraosseous ganglion (author’s transl). Z Orthop Ihre Grenzgeb 1977; 115(1): 67-75.
[PMID: 842091]
[75]
Kambolis C, Bullough PG, Jaffe HI. Ganglionic cystic defects of bone. J Bone Joint Surg Am 1973; 55(3): 496-505.
[http://dx.doi.org/10.2106/00004623-197355030-00005] [PMID: 4703202]
[76]
Kuhn JP, Berger PE. Computed tomographic diagnosis of osteomyelitis. Radiology 1979; 130(2): 503-6.
[http://dx.doi.org/10.1148/130.2.503] [PMID: 760169]
[77]
Hermann G, Rose JS. Computed tomography in bone and soft tissue pathology of the extremities. J Comput Assist Tomogr 1979; 3(1): 58-66.
[http://dx.doi.org/10.1097/00004728-197902000-00010] [PMID: 422793]
[78]
Azouz EM. Computed tomography in bone and joint infections. J Can Assoc Radiol 1981; 32(2): 102-6.
[PMID: 7251612]
[79]
Hald JD Jr, Sudmann E. Acute hematogenous osteomyelitis: early diagnosis with computed tomography. Acta Radiol Diagn (Stockh) 1982; 23(1): 55-8.
[http://dx.doi.org/10.1177/028418518202300108] [PMID: 7080856]
[80]
Hug I, Gunçaga J. Tumoral calcinosis with sedimentation sign. Br J Radiol 1974; 47(562): 734-6.
[http://dx.doi.org/10.1259/0007-1285-47-562-734] [PMID: 4433987]
[81]
Kolawole TM, Bohrer SP. Tumoral calcinosis with “fluid levels” in the tumoral masses. Am J Roentgenol Radium Ther Nucl Med 1974; 120(2): 461-5.
[http://dx.doi.org/10.2214/ajr.120.2.461] [PMID: 4814229]
[82]
Gordon LF, Arger PH, Dalinka MK, Coleman BG. Computed tomography in soft tissue calcification layering. J Comput Assist Tomogr 1984; 8(1): 71-3.
[http://dx.doi.org/10.1097/00004728-198402000-00015] [PMID: 6690528]
[83]
Zawin M, Katz LD, Lawson JP. Case report 500: Tumoral calcinosis in area of left hip. Skeletal Radiol 1988; 17(6): 450-3.
[http://dx.doi.org/10.1007/BF00361669] [PMID: 3238448]
[84]
De Smet AA, Norris MA, Fisher DR. Magnetic resonance imaging of myositis ossificans: Analysis of seven cases. Skeletal Radiol 1992; 21(8): 503-7.
[http://dx.doi.org/10.1007/BF00195231] [PMID: 1465642]
[85]
Shirkhoda A, Armin AR, Bis KG, Makris J, Irwin RB, Shetty AN. MR imaging of myositis ossificans: Variable patterns at different stages. J Magn Reson Imaging 1995; 5(3): 287-92.
[http://dx.doi.org/10.1002/jmri.1880050312] [PMID: 7633105]
[86]
Itai Y, Ohtomo K, Kokubo T, Yamauchi T, Okada Y, Makita K. CT demonstration of fluid-fluid levels in nonenhancing hemangiomas of the liver. J Comput Assist Tomogr 1987; 11(5): 763-5.
[http://dx.doi.org/10.1097/00004728-198709000-00003] [PMID: 2821088]
[87]
Di Benedetto G, Pierangeli M, Scalise A, Pauri F, Bertani A. Gigantic epidermoid cyst of the skull. Plast Reconstr Surg 1996; 97(6): 1246-8.
[http://dx.doi.org/10.1097/00006534-199605000-00024] [PMID: 8628809]
[88]
Rajeswaran G, Malik Q, Saifuddin A. The role of needle biopsy for focal bone lesions with complete fluid-fluid levels on magnetic resonance imaging. Skeletal Radiol 2013; 42(6): 765-9.
[http://dx.doi.org/10.1007/s00256-012-1542-y] [PMID: 23233249]
[89]
Sundaram M, Totty WG, Kyriakos M, McDonald DJ, Merkel K. Imaging findings in pseudocystic osteosarcoma. AJR Am J Roentgenol 2001; 176(3): 783-8.
[http://dx.doi.org/10.2214/ajr.176.3.1760783] [PMID: 11222226]
[90]
Traina F, Errani C, Toscano A, et al. Current concepts in the biopsy of musculoskeletal tumors: AAOS exhibit selection. J Bone Joint Surg Am 2015; 97(2)e7
[http://dx.doi.org/10.2106/JBJS.N.00661] [PMID: 25609446]
[91]
Errani C, Traina F, Perna F, Calamelli C, Faldini C. Current concepts in the biopsy of musculoskeletal tumors. ScientificWorldJournal 2013; 2013538152
[http://dx.doi.org/10.1155/2013/538152] [PMID: 23844403]
[92]
Rimondi E, Mavrogenis AF, Errani C, et al. Biopsy is not necessary for the diagnosis of soft tissue hemangiomas. Radiol Med (Torino) 2018; 123(7): 538-44.
[http://dx.doi.org/10.1007/s11547-018-0862-y] [PMID: 29476440]
[93]
Mavrogenis AF, Angelini A, Errani C, Rimondi E. How should musculoskeletal biopsies be performed? Orthopedics 2014; 37(9): 585-8.
[http://dx.doi.org/10.3928/01477447-20140825-03] [PMID: 25198351]
[94]
Rimondi E, Rossi G, Bartalena T, et al. Percutaneous CT-guided biopsy of the musculoskeletal system: results of 2027 cases. Eur J Radiol 2011; 77(1): 34-42.
[http://dx.doi.org/10.1016/j.ejrad.2010.06.055] [PMID: 20832220]
[95]
Jeon D-G, Song WS, Cho WH, Kong CB, Cho SH. Proximal tumor location and fluid-fluid levels on MRI predict resistance to chemotherapy in stage IIB osteosarcoma. Clin Orthop Relat Res 2014; 472(6): 1911-20.
[http://dx.doi.org/10.1007/s11999-014-3521-1] [PMID: 24574120]
[96]
Tang H, Moro A, Feng W, et al. Giant cell tumors combined with secondary aneurysmal bone cysts are more likely to develop postoperative recurrence: A retrospective study of 256 cases. J Surg Oncol 2019; 120(3): 359-65.
[http://dx.doi.org/10.1002/jso.25588] [PMID: 31219620]

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