This document provides information on different bone tumors categorized by location - epiphyseal, medullary, cortical, juxtacortical, and others. For each location, common tumor types are listed along with key characteristics such as appearance on imaging, affected age group, symptoms, and other relevant details. Additional sections provide descriptions of individual tumor types including osteoid osteoma, osteosarcoma, osteochondroma and others. Common imaging patterns are emphasized along with associated clinical features to aid in tumor diagnosis and differentiation.

4. Epiphysis:
 Pediatric (<20): Chondroblastoma
 Adult: Giant cell tumor (GCT)
 Other differentials:
 Osteomyelitis,
 Paget disease

5.  Medullary:
 Simple (unicameral) bone
cyst
 Aneurysmal
(multicameral) bone cyst
 Enchondroma
 Fibrous dysplasia
 Chondromyxoid fibroma
 Conventional
osteosarcoma
 Chondrosarcoma
 Osteochrondroma (most
common benign bone
tumor)
 Cortical:
 Fibrous cortical defect
(FCD)
 Non-ossifying fibroma
(NOF)
 Osteoid osteoma
 Juxtacortical:
 Juxtacortical chondroma
 Periosteal osteosarcoma
 Paraosteal osteosarcoma
 Juxtacortical
chondrosarcoma

6.  Osteoma - Skull
 Osteoid Osteoma/ Osteoblastoma
 Osteosarcoma
 Osteochondroma
 Chondroma
 Enchondroma
 Chondroblastoma
 Chondrosarcoma
 Ewing Sarcoma
 Giant CellTumor
 Fibrous Dysplasia
 Non ossifying fibroma
 Aneurysmal bone cyst
 Unicameral bone cyst

7.  Radiolucent nidus with sclerotic
border or vice versa, well-demarcated
 Metaphysis, Diaphysis
 Children/Adolescent
 Painful – relieved by NSAIDs/Aspirin
 Grossly “cherry red” nidus
 <2.0cm, if >2.0cm  Osteoblastoma
 Numbers vary depending on source

8.  Radiodense lesion with cortical
lifting Codman’s triangle or
“sunburst” appearance
 Metaphysis most common-
knee
 Rapid growth during adolescence-
teenager
 Pain, swelling, pathological fx
 Age: <20 y/o most and then >60
y/o peak
 Most common primary
malignant tumor young
adults

9.  Most common benign
osseous tumor in lower
limb
 Mushroom looking
exostosis
 Metaphysis region near
epiphyseal plate 
juxta cortical
 Young males- 10-30

10.  Radiolucent expansile lesion, can
calcify
 Metaphysis
 Can become malignant*, painless
but can present as swelling
 Enchondroma if arises from
medullary cavity
 Ollier’s – Multiple systemic
enchondromatosis (malignant)
 Maffucci’s – Ollier’s +
phleboliths/calcified
hemangiomas
 Most common benign osseous
tumor digits

11.  Radiolucent with
calcifications
 Epiphysis
 Children/Adolescent
 Growth plate open

12.  Radiodense with
calcifications, usually
located at surface of
bone
 Any location- hips,
pelvis, shoulder
 Adults
 Progressively painful

13.  Radiodensity with “onion-
skinning” of the periosteum
with cortical erosion
 Diaphysis of long bones
 Children/Adolescent
 Pain, swell, possible fever and
leukocytosis
 Most common primary
malignant tumor teenagers.
 chromosome translocation
11-22

14.  Aka Osteoclastoma
 Origin: osteoclasts
 Radiolucent multilocular
“soap bubble”
 Epiphysis to metaphysis of
long bones
 Wrist and knee joints
 Distal femur and proximal
tibia
 Adults- 20-55

15.  Radiolucent with
microcalcifications
 Metaphysis, Diaphysis
 Children/Adolescent
 Asymptomatic
 “Ground glass”
appearance

16.  Radiolucency that is
multilocular
 Metaphysis, usually at cortical
edges
 Children/Adolescent
 Almost all resolve
spontaneously, if not  Non-
ossifying fibroma

17.  Radiolucent, “blow-out”
appearance expansile
 Metaphysis
 Any age
 Vascular painful, grossly
red-brown, hot on bone
scan
 “Finger in balloon sign”
cortex intact

18.  Radiolucent well-
demarcated, non-
expansile
 Metaphysis
 Children/Adolescent
 Sanguinous fluid-filled,
asymptomatic
 “Falling fragment sign”
 Pathologic fracture

19.  Radiodense cortical
bone within cancellous
bone well-demarcated
 Any location
 Any age
 Multiple enostoses 
Osteopoicholosis may
have hypertrophic or
keloid scar formation

20.  Radiodense
calcifying soft tissue
 Any location
 Any age
 Trauma-induced,
growth from
periphery to center

21.  Radiodense
increasing size
 Any location
 Any age
 No hx trauma,
grows from center
to periphery

22.  Radiodense lytic lesions
 Any location
 Any age but more
common adults
 Commonly from
Prostate, Breast,
Kidney,Thyroid, Lungs,
Multiple Myeloma
(most common
primary malignant
bone tumor all ages)

23.  Chondromyxoid Fibroma
 Ecchondromas
 Interosseous lipoma
 Fibrosarcoma
 Osteoma (similar to osteochondroma
without cartilage cap)

24.  Paget’s/Ricket’s Flame shaped, Blades of grass
 Ricket’s widened physis and ant. bowing
 Osteopoikilosis  bone islands
 Osteopetrosis  bone on bone; marble bone disease;
stone bone
 Non-ossifying fibroma  bubbly; long lytic lesion in
long bone
 Melorheostosis  melted candle wax