osteolytiske

Osteolytiske is an adjective used in medical radiology and pathology to describe processes or lesions that cause osteolysis, i.e., bone resorption by osteoclasts leading to loss of cortical bone and lytic areas on imaging. The term derives from Greek roots osteo- bone and lysis dissolution; in Norwegian and Danish usage it describes radiographic or histopathologic features of bone destruction.

Pathophysiology and imaging: Osteolysis results from an imbalance between bone formation and resorption, typically due to osteoclast activation. Radiographically, osteolytic lesions appear as radiolucent areas in bone, often with diminished density, cortical thinning or breakthrough. Lesion margins can be well-defined (often benign) or ill-defined and aggressive. Patterns include geographic (round/oval with sclerotic rim), moth-eaten (multiple irregular lucencies), and permeative (tiny, woven lucencies with rapid destruction). CT and MRI help delineate extent and soft tissue involvement; PET-CT may assess metabolic activity.

Common causes: malignant (metastases from breast, lung, kidney; multiple myeloma), primary bone tumors (giant cell tumor), hematologic disorders (lymphoma), infectious osteomyelitis, Langerhans cell histiocytosis, fibrous dysplasia, simple bone cyst, aneurysmal bone cyst.

Clinical and management: Osteolytic lesions may cause pain, swelling, or pathologic fracture. Diagnosis often requires clinical correlation, imaging, and biopsy to determine etiology. Treatment targets the underlying condition and may include surgery for stabilization, radiotherapy or chemotherapy for malignancy, antibiotics for infection, and supportive measures such as bisphosphonates to reduce resorption.

Prognosis: depends on cause; malignant osteolysis generally requires oncologic management, while benign lesions may be monitored or treated with curettage or resection.