Although the utility of radiographs in stratifying bone lesions by biological activity is well established, there is sparse literature documenting concrete values on accuracy. A prospective study evaluating 200 consecutive bone tumors of the hand showed that subjective grading of tumors based on radiographic features provided a correct categorization of tumor grade (benign versus malignant) in 82.5% of cases [7]. In a retrospective study applying a modified Lodwick-Madewell grading system to categorize 183 bone tumors, Caracciolo et al [8] found that a low radiographic grade assignment correlates with benignity and that increasing grade correlates with an increasing risk of malignancy. It should be noted that accurate radiographic characterization of some primary bone tumors (such as low-grade cartilage lesions) is inherently difficult because of overlapping radiographic features of some benign and malignant chondroid lesions. Crim et al [9] performed a retrospective review of 53 cases of low-grade cartilage lesions (enchondroma and grade 1 chondrosarcoma) and found that radiographs suggested the correct diagnosis of enchondroma in 67.2% of cases and the correct diagnosis of chondrosarcoma in only 20.8% of cases. In a retrospective analysis of 35 enchondromas and 43 central grade 1 chondrosarcomas, Geirnaerdt et al [10] found that morphologic features seen on radiographs in combination with clinical symptoms did not improve the ability to differentiate between enchondromas and central grade 1 chondrosarcomas. Bone Scan Whole Body Bone scan is not routinely used in the initial evaluation of primary bone tumors. There is no relevant literature regarding the use of Tc-99m bone scan in the initial imaging of primary bone tumors. US Area of Interest Ultrasound (US) is not routinely used in the initial evaluation of primary bone tumors. There is no relevant literature regarding the use of US in the initial imaging of primary bone tumors. Variant 2: Suspect primary bone tumor.
Primary Bone Tumors. Although the utility of radiographs in stratifying bone lesions by biological activity is well established, there is sparse literature documenting concrete values on accuracy. A prospective study evaluating 200 consecutive bone tumors of the hand showed that subjective grading of tumors based on radiographic features provided a correct categorization of tumor grade (benign versus malignant) in 82.5% of cases [7]. In a retrospective study applying a modified Lodwick-Madewell grading system to categorize 183 bone tumors, Caracciolo et al [8] found that a low radiographic grade assignment correlates with benignity and that increasing grade correlates with an increasing risk of malignancy. It should be noted that accurate radiographic characterization of some primary bone tumors (such as low-grade cartilage lesions) is inherently difficult because of overlapping radiographic features of some benign and malignant chondroid lesions. Crim et al [9] performed a retrospective review of 53 cases of low-grade cartilage lesions (enchondroma and grade 1 chondrosarcoma) and found that radiographs suggested the correct diagnosis of enchondroma in 67.2% of cases and the correct diagnosis of chondrosarcoma in only 20.8% of cases. In a retrospective analysis of 35 enchondromas and 43 central grade 1 chondrosarcomas, Geirnaerdt et al [10] found that morphologic features seen on radiographs in combination with clinical symptoms did not improve the ability to differentiate between enchondromas and central grade 1 chondrosarcomas. Bone Scan Whole Body Bone scan is not routinely used in the initial evaluation of primary bone tumors. There is no relevant literature regarding the use of Tc-99m bone scan in the initial imaging of primary bone tumors. US Area of Interest Ultrasound (US) is not routinely used in the initial evaluation of primary bone tumors. There is no relevant literature regarding the use of US in the initial imaging of primary bone tumors. Variant 2: Suspect primary bone tumor.