Solitary bone lesions are common diagnostic dilemmas. Conventional radiography is frequently the initial imaging study for evaluation. This article provides an organized approach to analyzing and categorizing these lesions based on radiographs, emphasizes the development of a reasonable and accurate differential diagnosis, and guides the referring physician if further imaging evaluation is warranted. Use of clinical information and analysis of specific radiographic features, including lesion location, rate of growth, the presence and character of periosteal reaction, tumor matrix, and the presence of an associated soft tissue mass is reviewed. Radiographic evaluation of soft tissue masses is briefly discussed.
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