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Differential Diagnosis of Bone Lesions

Although a variety of methods can be used in developing a differential diagnosis for a bone lesion, an anatomical approach is most useful. The analysis of the question, where is the lesion? is critical in this approach.

This section focuses on the various locations for localization of tumors, providing a short summary of the best way to determine the likelihood of diagnosis. In each category, mesenchymal lesions are grouped in the following order:

  • Bone lesions
  • Cartilage lesions
  • Fibrous lesions
  • Other histology

The differential diagnostic lists for many of these anatomical locations are extensive. However, using the criteria listed in the section on presenting complaints and the section on radiographic analysis will help the clinician rule out diagnoses that do not fit the biological behavior observed in the lesion and retain lesions that do fit the radiographic criteria.

Differential Diagnosis by Anatomic Location

  • Polyostotic conditions
  • Juxta-articular bone lesions
  • Epiphyseal bone lesions
  • Epiphyseal-metaphyseal bone lesions
  • Metaphyseal and metaphyseal-diaphyseal bone lesions
  • Diaphyseal bone lesions
  • Parosteal bone lesions
  • Anterior bone spine
  • Posterior bone spine
  • Sacrum bone lesions

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