Approach to Interpretation and Pictorial Review of the Radiographic Appearance of Calvarial Lesions in Adults

In our experience, radiologists are becoming less confident and less comfortable with interpreting skull radiographs, likely as a result of a shift in radiology residency training toward cross-sectional imaging. However, radiographic interpretation of skull radiographs remains relevant in current radiology practice, especially in the evaluation of multiple myeloma and postinstrumentation. In our opinion, an accurate radiographic diagnosis of calvarial abnormalities requires the following: 1) an understanding of the anatomy and normal radiographic appearance of the calvaria, 2) a systematic approach to the interpretation of the calvaria, and 3) knowledge of the common types of calvarial lesions encountered. The aim of this pictorial review was to outline our approach to skull radiograph interpretation and to provide radiologists with a compendium of illustrative radiographic examples of calvarial pathology.

Learning Objective: Develop an approach to interpretation of skull radiography and recognize common calvarial pathology.