The role of plain radiographs in management of bone metastases

J Palliat Med. 2009 Feb;12(2):195-8. doi: 10.1089/jpm.2008.0055.


Approximately 50% of patients with cancer will develop skeletal metastases, which often lead to significant pain. When a patient complains of pain, a bone scan and/or plain x-rays are ordered as investigations. X-rays necessitate a 1-cm diameter mass and 50% bone mineral loss at minimum for detection. Up to 40% of lesions will be unidentified by x-rays, presenting false-negative results. Computed tomography (CT) scans can recognize a bony metastatic lesion up to 6 months earlier than an x-ray. However, plain x-rays can also lead to rare false-positive results. We present a case with a false-positive result in a patient with lung cancer.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Bone Neoplasms / complications
  • Bone Neoplasms / diagnostic imaging*
  • Bone Neoplasms / secondary*
  • False Positive Reactions*
  • Humans
  • Lipoma / diagnostic imaging
  • Lung Neoplasms / pathology
  • Male
  • Pain / etiology
  • Tomography, X-Ray Computed