Objective: To clarify the valuable clinical features and diagnostic imaging findings regarding the diagnosis of osteosarcoma of the jaw (OSJ). Materials and methods: The initial symptoms and diagnostic imaging findings of 10 patients with OSJ were analysed. The points analysed on the diagnostic images were as follows: any widening of the periodontal ligament space of the teeth on the periphery of the OSJ; the presence of radial spicules and Codman's triangle; any signs of bone destruction; and the patterns of osteogenesis. Results: All patients had pain and/or swelling of the affected site, and all OSJs, except for one edentulous case, showed a widening of the periodontal ligament space of the teeth on the periphery of the OSJ. Radial spicules or Codman's triangle were observed in only three cases (30%). Four out of five mandibular OSJs were osteolytic or osteolytic dominant with bone destruction, while, in contrast, four out of five maxillary OSJs were osteogenic or osteogenic dominant, and three out of the four maxillary OSJs did not show bone destruction. The osteogenic OSJ without bone destruction was similar to some benign cemento-osseous lesions of the jaw and thus was difficult to diagnose as OSJ based on the diagnostic imaging findings alone. Conclusion: Even though some OSJ showed features similar to the benign tumours of the jaw bone based on the diagnostic imaging findings, the pain and swelling of the affected site, and the widening of the periodontal ligament space of the teeth on the periphery of OSJ were considered to be common findings, which may help in making an accurate diagnosis of OSJ in this limited series.
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