[Differential diagnosis of benign bone tumors. Clinical aspects and imaging procedures]

In the assessment of bone tumors and tumor-like lesions the first aim is to clarify potential malignancy and aggressiveness. To rely exclusively on clinical assessment is not sufficient. Imaging techniques are invaluable, the most important still being plain roentgenograms. Radiological assessment according to the Lodwick grading system is useful. MRI has now been established to be superior to further investigations. Ultrasonography has proved to be helpful as a noninvasive and cost-saving screening method, particularly in the presence of non pathologic X-ray findings and persistent complaints. Only non-ossifying fibroma and osteochondroma can be diagnosed reliably with X-ray. For solitary bone cysts, chondromas of small tubular bones and fibrous dysplasia, X-ray diagnosis can be doubtful. Most of the lesions to be considered have to be verified histologically. Specialized experience is necessary for the best selection and timing of diagnostic measurements in individual cases in order to prevent fatal errors.