Radiology · patient case question
What is the name of this radiographic pattern?
Patient case: Case: multiple punched-out radiolucencies
Scenario: A radiograph shows numerous well-defined radiolucencies scattered through the jaws, without corticated margins and without any relationship to the teeth. Three linked questions followed.
Show answer and explanation
Correct answer: B. "Punched out"
- A. A cotton-wool appearance — mixed radiopaque patches on a dense background — belongs to the late (osteoblastic) stage of Paget disease of bone.
- B. Correct. Multiple sharply defined radiolucencies that look as though they were stamped out of the bone, with no corticated rim, are the classic punched-out lesions of multiple myeloma.
- C. Soap-bubble multilocularity is described for ameloblastoma and odontogenic myxoma; those are expansile multilocular lesions, not scattered discrete holes.
- D. A salt-and-pepper trabecular pattern with loss of the lamina dura is seen in hyperparathyroidism.