Bone Tumors: Radiographic Pitfalls

Focal bone lesions are quite commonly encountered and can be identified incidentally on radiographs or as part of a focused diagnostic evaluation. Many of these bone lesions are not true bone tumors and can be potential pitfall on radiographs. These potential radiographic pitfalls include pseudo-lesions, normal anatomical variants, and other benign osseous lesions such as Brodie abscess, fibrous dysplasia, stress fracture, bone infarct, myositis ossificans, brown tumor, and subchondral cyst. Recognizing these entities and distinguishing them from bone tumors is a critical radiological skill. A radiologist should have a basic understanding of the epidemiology, symptomatology, classic anatomical locations, characteristic imaging appearances, and differential diagnosis of these potential bone tumor pitfalls in order to avoid misdiagnosis and unnecessary interventions.