Background: Conventional medullary osteosarcoma is a malignant bone-forming tumor characterized by the production of osteoid matrix by malignant mesenchymal cells. Although it is the most common primary malignant bone tumor in children, primary osteosarcoma of the spine is exceptionally rare, accounting for less than 5% of pediatric osteosarcomas. Symptoms are frequently nonspecific, and early radiographic clues may be subtle. Due to its rarity and nonspecific presentation, spinal osteosarcomas are often diagnosed late, typically after structural destruction or neurologic compromise has occurred. Case Report: A 12-year-old female presented with two months of progressive low back pain and an unintentional 15-pound weight loss. She denied weakness, sensory loss, or bowel/bladder dysfunction. Lumbar spine radiographs revealed a lucency of the left L2 pedicle, producing a “winking owl sign.” Follow-up CT demonstrated a lytic, destructive lesion with asymmetric enlargement of the left psoas and paraspinal musculature. Additionally, CT was useful in demonstrating the presence of osseous matrix within the primary tumor. MRI revealed an expansile, enhancing lesion centered in the left posterior elements of L2, with paraspinal soft-tissue extension and circumferential epidural involvement causing moderate to severe canal stenosis. Biopsy confirmed the diagnosis of conventional medullary osteosarcoma. The patient remained neurologically intact and was referred for multidisciplinary oncologic management. Read More

Meeting name: SPR 2026 Annual Meeting , 2026

Authors: Joya Sosa Yocelin, Madden Joseph, Fadell Michael, Carrico Caroline, Maxfield Charles, Cao Joseph

Keywords: Oncology, Osteosarcomas, Radiographic Findings

Pectus excavatum is the most common chest wall deformity, often causing psychosocial distress and cardiopulmonary issues when severe. The Haller Index (HI) obtained on CT remains the standard for assessing severity, despite its limitations and reproducibility on radiograph. Photon-counting detector CTs can reduce radiation dose while maintaining image quality. We hypothesize that significantly lowering radiation will not compromise presurgical evaluation of pectus excavatum. Read More

Meeting name: SPR 2026 Annual Meeting , 2026

Authors: Cao Joseph, Kuchibhatla Maragatha, Janos Sara, Gupta Ananya, Bache Steve, Solomon Justin, Kilpatrick Kayla, Fadell Michael, Gaca Ana, Maxfield Charles, Carrico Caroline

Keywords: Chest Computed Tomography (CT), Surgical Planning, Radiation Reduction