DDX of malignant bone tumors

Approach to the DDX of malignant bone tumors:

  • Location (diaphysis, metaphysis, epiphysis, abut articular surface)
  • Lytic or blastic
  • Matrix (chondroid, osseous, fibrous)
  • Zone of transition (wide, narrow)
  • Periosteal new bone or cortical destruction

In general, malignant bone tumors tend to have a wide zone of transition with periosteal new bone formation or cortical destruction