Radiologists frequently encounter solitary bone lesions in daily practice. The interpreting radiologist has the onus to determine the level of suspicion and appropriate next-step recommendations to aid in timely healthcare decisions. Lesion imaging characteristics in conjunction with patient history and demographics ultimately determine if a bone lesion is benign. Lesions that cannot be confidently disregarded as benign and clinically insignificant require further evaluation through additional imaging, tissue sampling, or both. We review a diagnostic imaging approach to solitary bone lesions with case examples that detail real-world thought processes for interpretations and practical next-step recommendations.
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