# An Unusual MRI Appearance of Osseous Metastases

## TL;DR

This paper describes a rare MRI appearance of bone metastases that resembled a different condition, helping to improve their identification.

## Contribution

The paper presents a previously unreported lamellated MRI appearance of osseous metastases.

## Key findings

- MRI showed multiple lamellated lesions in the distal femur, confirmed as metastatic disease.
- The appearance was initially mistaken for CPPD arthropathy based on radiographic and CT findings.
- This case highlights the importance of recognizing unusual metastatic appearances for accurate diagnosis.

## Abstract

Bone metastases can present in a wide variety of appearances across all imaging modalities. We present a unique appearance of a distal femoral metastasis in a patient who initially complained of knee pain. The radiographic and CT findings were initially suspicious for calcium pyrophosphate deposition (CPPD) arthropathy; however, an MRI demonstrated multiple lesions with a lamellated appearance confirmed on biopsy to be metastatic disease. This unusual lamellated appearance has not been previously described. We present this case to help distinguish this entity radiographically and better classify this finding as a manifestation of metastatic disease.