Fig. 2
From: Proton MR spectroscopy in characterization of focal bone lesions of peripheral skeleton
An18-year-old male patient with swelling and pain right knee. a. AP radiograph of right knee. Permeative lysis is seen in the right distal femoral metaphysis with pathological fracture (arrow). b. Lateral radiograph of right knee. Interrupted type of periosteal reaction is evident with Codman’s triangle (arrow) and soft tissue component (asterisk). c. Post contrast T1 weighted sagittal image. Distal femoral metadiaphyseal destructive lesion with cortical erosion (long arrow) and soft tissue mass denoted by (short arrow). d. Post contrast fat saturated T1 weighted axial image. Thick irregular nodular enhancing septae (arrow), are seen interspersed with numerous non enhancing cystic areas. e. MRS shows small Choline peak at 3.2 ppm (arrow). f. HNE100X showing multiple cystic spaces containing blood lying by cyst wall showing presence malignant cells along with osteoid and giant cells suggestive of telangiectatic osteosarcoma