Radiologic Diagnosis

Radiographic Imaging of Musculoskeletal Neoplasia

“…When attempting to diagnose a bone lesion on radiographic criteria alone, several parameters may aid in the formulation of an appropriate differential diagnosis. 6 These parameters include the following: (1) age of the patient (eg, round cell lesions may present as eosinophilic granuloma in the first decade, Ewing's sarcoma in the second decade, lymphoma in the fourth or fifth decade, and myeloma thereafter), (2) location of the lesion (eg, chondroblastoma or giant cell tumor is found in the epiphyseal or subchondral location or fibrous dysplasia in the diaphysis), (3) singularity or multiplicity of the lesion (multiplicity suggests such lesions as metastasis, histiocytosis X, or enchondromata), (4) size of the lesion (larger lesions tend to be more aggressive), (5) presence of tumor matrix (discussed above), and (6) local behavior of the lesion (also discussed above). Careful attention to these parameters will assist the clinician in the formation of a reasonable differential diagnosis.…”