Differential Diagnosis for Bone Lesions
January 9, 2021
| By :
OrthoFixar
|
Orthopedic Pathology
| Last updated on April 28, 2021
What are the Differential Diagnosis for Bone Lesions based on the location of the bone?
Bone lesions can be found in any location of the bone, but every location of the bone has it’s own lesions.
| Bone Section | Lesions |
|---|---|
| Epiphyseal Lesions | ■ Chondroblastoma (ages 10-25) ■ Giant cell tumor (ages 20-40) ■ Clear chondrosarcoma (rare) |
| Diaphyseal Lesions | ■ Ewing sarcoma (ages 5-25) ■ Lymphoma (adult) ■ Fibrous dysplasia (ages 5-30) ■ Adamantinoma (consider in the tibia) ■ Histiocytosis (ages 5-30) |
| Spine Lesions | Older than 40 Years: ■ Metastases ■ Multiple myeloma ■ Hemiangioma ■ Chordoma (in sacrum) Younger than 30 Years: ■ Vertebral body ■ Histiocytosis ■ Hemangioma ■ Posterior elements ■ Osteoid osteoma ■ Osteoblastoma ■ Aneurysmal bone cyst |
| Multiple Lesions | ■ Histiocytosis ■ Enchondroma ■ Osteochondroma ■ Fibrous dysplasia ■ Multiple myeloma ■ Metastases ■ Hemangioma ■ Infection ■ Hyperparathyroidism |
What are the Differential Diagnosis for Bone Lesions based on the bone type?
| Bone | Lesions |
|---|---|
| Sacrum in young patients (10-40) | – Giant cell tumor – ABC – Ewing’s – Osteosarcoma |
| Sacrum in older patients (40-80) | – Chordoma – Metastasis – Myeloma – Lymphoma – Chondrosarcoma – MFH |
| Tibial lesions | – Adamantinoma – Osteofibrous dysplasia – Fibrous dysplasia – Osteomyelitis |
| Hand and Foot Intramedullary destructive lesions | – Enchondroma – Giant cell tumor – ABC – Giant cell reparative granuloma – Metastatic carcinoma (only in older patients) |
What are the Differential Diagnosis for Bone Lesions based on age?
| Age | Benign Lesions | Malignant Lesions |
|---|---|---|
| Infants and children (0 to 5 years) | – Osteomyelitis – Osteofibrous dysplasia | – Metastatic rhabdomyosarcoma – Metastatic neuroblastoma – Leukemia |
| Young patient (10-40 years) | – NOF – Osteoid osteoma – Giant cell tumor – ABC – UBC – Osteochondroma & MHE – Chondroblastoma – Fibrous dysplasia – Osteomyelitis – Eosinophillic granuloma | – Osteosarcoma – Ewing’s – Desmoplastic fibroma – Leukemia – Lymphoma |
| Older patient (40-80 years) | – Enchondroma – Bone infarct – Bone island – Paget’s disease -Hyperparathyroidism | – Metastatic bone disease – Myeloma – Lyphoma – Chondrosarcoma – MFH – Secondary sarcoma (Paget’s, irradiation) |
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