Bone or cartilage mass evaluation

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]

Overview

The evaluation of bone or cartilage mass will depend on detailed medical history, age, and morphology of the lesion.[1]

Bone or Cartilage Mass Evaluation

The algorithm below summarizes the initial bone and cartilage mass evaluation that differentiate bone and cartilage tumors according to detailed history, age, and morphology of the lesion.

Adult Bone or Cartilage Mass Evaluation


 
 
 
 
 
Initial patients evaluation
 
 
 
 
 
 
 
 
 
 
History and Symptoms
❑ Bone pain: characteristics
❑ Response to analgesics
❑ Recent fracture
❑ Personal history of cancer
Physical examination
❑ Local swelling or mass
Age
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Imaging
 
 
 
 
 
 
1) Conventional radiography
❑ What type of bone is involved?
❑ Location of the lesion
❑ Morphology of the lesion
❑ Type of calcified matrix involved
❑ Size
2) CT/MRI scan
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Children and adolescents
 
Adults
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Lesion characteristics
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Well-defined
Listed in frequency order
 
Ill-defined lesions
Listed in frequency order
 
Sclerotic lesions
Listed in frequency order
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
❑ Metastases
❑ Myeloma
❑ Lymphoma
❑ Bone cyst
❑ Brown tumor
 
❑ Metastases
❑ Giant cell tumor
❑ Myeloma
❑ Chondrosarcoma
 
❑ Enchondroma
❑ Osteoma
❑ Fibrous dysplasia
❑ Bone islands
❑ Infection


Pediatric Bone or Cartilage Mass Evaluation


 
 
 
 
 
Initial patients evaluation
 
 
 
 
 
 
 
 
 
 
History and Symptoms
❑ Bone pain: characteristics
❑ Response to analgesics
❑ Recent fracture
❑ Personal history of cancer
❑ Failure to thrive
Physical examination
❑ Local swelling or mass
Age
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Imaging
 
 
 
 
 
 
1) Conventional radiography
❑ What type of bone is involved?
❑ Location of the lesion
❑ Morphology of the lesion
❑ Type of calcified matrix involved
❑ Size
2) CT/MRI scan
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Adults
 
Children and adolescents
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Lesion characteristics
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Well-defined
Listed in frequency order
 
Ill-defined lesions
Listed in frequency order
 
Sclerotic lesions
Listed in frequency order
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
❑ Simple bone cyst
❑ Infection
❑ Fibrous dysplasia
❑ Aneurysmal bone cyst
❑ Non ossifying fibroma
❑ Chondroblastoma
❑ Chondromyxoid fibroma
 
❑ Ewing tumor
❑ Osteosarcoma
❑ Infection
❑ Eosinophilic granuloma
 
❑ Osteosarcoma
❑ Osteoid osteoma
❑ Fibrous dysplasia
❑ Eosinophilic granuloma
❑ Infection


References

  1. Balach T, Stacy GS, Peabody TD (2011). "The clinical evaluation of bone tumors". Radiol. Clin. North Am. 49 (6): 1079–93, v. doi:10.1016/j.rcl.2011.07.001. PMID 22024289.