Radiology as gross pathology in evaluating chondroid lesions

The study of large ("whole mount") histologic sections underscores the complexity of bone lesions and explains the great potential for misdiagnosis when a limited biopsy sample is assumed to be totally representative. Diagnostic pitfalls can generally be avoided by insisting on the opportunity for clinical-radiologic-pathologic correlation ("triangulation") before a final diagnosis is made. Essential to the method of triangulation is equal attention to the three lines of evidence. The ability to render reliable, clinically relevant, and individually pertinent consultations (as opposed to purely histologic opinions) derives from pursuing questions until all lines of evidence point ("triangulate") to the same answer. This is especially true in the realm of cartilage tumors where the limitations of histopathology are widely acknowledged. In this review, the use of radiographic data will be explored in general terms and in the special context of chondroid lesions.