Bone Tumors: MRI Pitfalls

Bone tumors are a relatively infrequent finding in musculoskeletal radiology, and malignant bone tumors are far less common than benign ones. A wide range of musculoskeletal tumors and tumor-like conditions may be encountered when patients undergo radiological examinations. The imaging features of certain normal, reactive, benign, inflammatory, traumatic, and degenerative processes, as well as the tumor-like lesions in the musculoskeletal system, may mimic malignant tumor. Misinterpretation of the imaging findings can lead to inappropriate clinical management of the patient. Although the differential diagnosis of primary bone tumor remains based on their radiographic appearances, it is necessary to define the tumor characterization and do staging for treatment planning in bone tumors and tumor mimics. Magnetic resonance imaging (MRI) is the most sensitive and accurate imaging technique for evaluation of bone and soft tissue tumors. However, some of normal variants, congenital or acquired bone disorders, traumatic changes, and tumor mimics can sometimes be confused with bone tumors on MRI. In the evaluation of bone tumors with MRI, the radiologist should be familiar with the imaging findings of non-tumoral and tumor-like lesions which may cause confusion.