X-ray
Lateral
Lateral
There is an aggressive, malignant appearing lytic lesion in the shaft of the fibula.
Periosteal reaction:
- perpendicular spiculations producing a sunburst appearance in the centre of the tumour
- there is also a laminated appearance towards the distal edge of the tumour producing an onion-skin appearance
- note the interrupted periosteal reaction (Codman triangle) at the proximal margin of the lesion
Associated soft tissue swelling.