Musculoskeletal neoplasia: helping the orthopaedic surgeon establish the diagnosis

Encountering musculoskeletal neoplasia in the clinical practice of orthopaedic surgery is a rather uncommon event but can be an anxiety-provoking experience when it occurs. Using a systematic approach to imaging these lesions includes evaluation via plain radiographs and other modalities such as bone scintigraphy (BS), computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET). By applying specific imaging characteristics obtained from these different modalities, the radiologist and orthopaedic surgeon can jointly create an appropriate differential diagnosis. The radiologist plays a key role as part of the diagnostic team, including providing crucial support for biopsy and staging. This article discusses a systematic approach in the evaluation and staging of musculoskeletal neoplasia from the perspective of supporting the orthopaedic surgeon.