DIAGNOSTIC STRATEGIES IN BONE-TUMORS AND TUMOR-LIKE LESIONS

Real bone tumors are rarely encountered in the daily routine of radiol ogical practice. Therefore, for a general radiologist there is no need for a specialist knowledge on this field. However, he should be able to distinguish benign from malignant lesions in order to avoid unneces sary biopsies. A systematic approach towards osteolytic lesions, e. g. according to the classification of Lodwick, is mandatory. CT and MRI are indicated to clear up the anatomy in areas of superposition artefa cts in conventional radiology and to determine the inner structure of a lesion, e. g. fatty tissue, liquid/solid. This paper highlights the advantages and disadvantages and the cost-effective use of the imaging modalities including scintigraphy in the diagnosis of bone tumors and tumor-like lesions. Guidelines for the management of bony lesions wil l be given in detail. The option and necessity for a specialist second opinion is emphasized.