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[Conventional radiological diagnosis of benign none neoplasms].

Der Orthopäde 2017 June
BACKGROUND: Benign bone tumors are of special clinical importance because they might be confused with malignant bone tumors.

OBJECTIVES: The aim of this article it to present the characteristics of benign bone tumors. The focus is orientated towards conventional x‑ray as the essential pillar for primary diagnosis. Consequently, the description of signal intensities of benign bone tumors in magnetic resonance images or less helpful clues like male-female ratios are deliberately omitted.

RESULTS: The classification of bone tumors introduced by Lodwick allows the identification of benign growth patterns. Growth patterns will not help, for example, in case of dedifferentiation of benign chondroid tumors towards chondrosarcomas. Therefore, each diagnosis has to incorporate the patient's clinical scenario. Furthermore, benign bone tumors might also cause aggressive growth patterns. Tumors classified as Lodwick Ic or higher should not be automatically regarded as malignant. Naturally, further clarification is mandatory for these tumors.

CONCLUSIONS: Differentiation between definitely benign bone tumors and those which need further work up is a critical diagnostic step. In the majority of cases, this is possible based on the appearance in conventional x‑ray images. In case of possibly malignant lesions, both the patient's symptoms and the x‑ray morphology have to be considered by orthopedic surgeons, pathologists, and radiologists to determine the optimal diagnostic strategy.

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