Citation, DOI, disclosures and article data
Citation:
Niknejad M, MacManus D, Wilczek M, et al. Leave alone lesions - skeletal. Reference article, Radiopaedia.org (Accessed on 21 Mar 2025) https://doi.org/10.53347/rID-23003
Skeletal leave alone lesions, also called “don't touch” or "do-not-touch" lesions, are so characteristic radiographically that further diagnostic tests such as a biopsy are unnecessary and can be frankly misleading and lead to additional unnecessary surgery. Thus, a radiologic diagnosis should be made without a list of differential possibilities.
These lesions can be divided into three categories - post-traumatic lesions, normal variants, and lesions that are real but obviously benign.
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History and etymology
Initially described by the renowned musculoskeletal radiologist Clyde Helms in the chapter of his book entitled "don't touch lesions" 1, 12.
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1. William E. Brant, Clyde A. Helms. Fundamentals of Diagnostic Radiology. (2012) ISBN: 9781608319114 - Google Books
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2. Barnes G & Gwinn J. Distal Irregularities of the Femur Simulating Malignancy. Am J Roentgenol Radium Ther Nucl Med. 1974;122(1):180-5. doi:10.2214/ajr.122.1.180 - Pubmed
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3. Martel W, Seeger J, Wicks J, Washburn R. Traumatic Lesions of the Discovertebral Junction in the Lumbar Spine. AJR Am J Roentgenol. 1976;127(3):457-64. doi:10.2214/ajr.127.3.457 - Pubmed
-
4. Phoebe Kaplan, Clyde A. Helms, Robert Dussault et al. Musculoskeletal MRI. (2001) ISBN: 0721690270 - Google Books
-
5. Wolfgang Dähnert. Radiology Review Manual. (2011) ISBN: 9781609139438 - Google Books
-
6. Lane F. Donnelly. Pediatric Imaging. (2009) ISBN: 9781416059073 - Google Books
-
7. Ralph Weissleder. Primer of Diagnostic Imaging. (2007) ISBN: 9780323040686 - Google Books
-
8. Minderhoud J, Braakman R, Penning L. Os Odontoideum, Clinical, Radiological and Therapeutic Aspects. J Neurol Sci. 1969;8(3):521-44. doi:10.1016/0022-510x(69)90011-2 - Pubmed
-
9. Onitsuka H. Roentgenologic Aspects of Bone Islands. Radiology. 1977;123(3):607-12. doi:10.1148/123.3.607 - Pubmed
-
10. Gill D & Clark W. Avulsion of the Ischial Apophysis. Aust N Z J Surg. 1996;66(8):564-5. doi:10.1111/j.1445-2197.1996.tb00814.x - Pubmed
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11. Fonseca E, Castro A, Kubo R et al. Musculoskeletal "Don't Touch" Lesions: Pictorial Essay. Radiol Bras. 2019;52(1):48-53. doi:10.1590/0100-3984.2016.0225 - Pubmed
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12. Hegde G, Azzopardi C, Patel A, Davies A, James S, Botchu R. “Do-Not-Touch” Lesions of Bone Revisited. Clin Radiol. 2022;77(3):179-87. doi:10.1016/j.crad.2021.11.012 - Pubmed
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