Bone lesions are commonly seen when reporting pediatric skeletal imaging. Distinguishing aggressive from nonaggressive lesions is essential in making the diagnosis. Not all aggressive lesions are neoplastic; indeed, osteomyelitis frequently presents with aggressive appearances and is far more commonly seen in the pediatric population than neoplastic lesions. In this article, we discuss an approach for the diagnosis of pediatric bone tumors and tumor-like conditions. The most common pediatric benign and malignant bone tumors are discussed in more detail.

Lumps and bumps are frequently seen in children, and the vast majority are a result of trauma, infection, or inflammation. True soft tissue neoplastic lesions are rare; however, their wide and complex classifications make these lesions challenging to manage. Imaging features are usually nonspecific, and a reasonable list of differential diagnoses can be generated following consideration of the clinical presentation, age, and anatomical location of the lesion. In this article, we offer a practical approach to diagnosing such lesions by discussing the most common three benign and malignant lesions in different anatomical regions stratified by age with emphasis on certain features that might aid in the diagnosis such as depth, multiplicity, calcification, or other specific imaging feature.

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