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Bone cancer X-rays

What does bone cancer look like on an X-ray?

Reading X-rays is a specialist job. Most of us can't make much out of them, unless it is something really obvious like a complete break in a bone.

Bone cancer may show up as a thinning of the bone, so the affected area may look paler and less dense on the X-ray. Cancer can lead to a break in a bone, called a pathological fracture. A pathological fracture happens in abnormal bone because it is weak. It can happen after a minor knock or when doing routine activities. Pathological fractures can show up quite clearly in X-rays, like any other break.

Most cancer cells in bones have spread there from another part of the body. These are called bone metastases, or secondary bone cancers. Primary bone cancer can look quite different and may show as an expansion on the side of the bone where the tumour has grown out from the bone itself. This may look like a shadowy area extending out from the affected bone. The tumour can lay down calcium deposits in this outgrowth and these may show up on X-ray as clearly defined white patches. Your doctor may call this sclerotic changes or sclerosis. Sclerosis means hardening. Secondary prostate cancer in the bones commonly has a dense, sclerotic appearance.

Sometimes the bone has a lacy appearance. The cancer causes holes to develop in the bone, making it look like lace or net. Your doctor may describe these changes as lysis or lytic changes. Lytic means cells that hat been broken down. 

The type of primary bone cancer called osteosarcoma often looks dense (sclerotic) on X-ray. Or it may be a mixture of thickened areas and holes. Doctors call these areas sclerotic and lytic. You may see these terms used on the X-ray report.

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Updated: 21 January 2015