Osteosarcoma differential diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohammadmain Rezazadehsaatlou[2].

Overview

Osteosarcoma must be differentiated from other diseases such as: any type of bone lesions caused by infection and/or tumors. Features such as the eccentric location of the tumor in the metaphyseal portion of the bone and the skeletal location help to distinguish osteosarcoma from Ewing sarcoma. Bone metastases from other primary tumours, less frequent in the young than in adult patients, should also be considered.

Differentiating Osteosarcoma from other Diseases

Osteosarcoma must be differentiated from:Osteomyelitis, Pediatric Osteomyelitis, Rhabdomyosarcoma, Pediatric Rhabdomyosarcoma, Chondrosarcoma, Metastases from other malignancies, Fibrous dysplasia, Giant cell tumors, Ewing's sarcoma, Malignant fibrous histiocytoma, Lymphoma Osteoblastoma, Aneurysmal bone cyst, Fibrosarcoma and Cortical desmoid.

Disease	Bone involvement	Bone pain	Fever	Fractures	Mechanism	ALK level	Diagnosis
Osteoblastoma	Single	Yes	No	Yes	Neoplasm	High	Radiology and biopsy
Osteosarcoma	Single	Yes	No	Yes	Neoplasm	Normal	Radiology and biopsy
Osteoid osteoma	Single	Yes	No	Yes	Neoplasm	High	Radiology and biopsy
Aneurysmal bone cyst	Single	Yes	No	No	Neoplasm	High	Radiology and biopsy
Stress fracture	Multiple	Yes	No	Yes	Stress	Normal	Radiology
Osteomyelitis	Single	Yes	Yes	No	Infection	Normal	Radiology and biopsy
Brodie's abscess	Single	Yes	Yes	No	Infection	Normal	Radiology and biopsy