Table 3 Differential diagnosis of sclerotic and lytic bone lesions
Causes of sclerotic bone lesions | Causes of lytic bone lesions | Causes of mixed sclerotic and lytic lesions |
|---|---|---|
Bone islands | Fibrous dysplasia | Fibrous dysplasia |
Bone infarcts | Fibrous cortical defect/ non-ossifying fibroma | Chronic recurrent multifocal osteomyelitis and SAPHO spectrum disorders |
Chronic osteomyelitis | Giant Cell Tumor | Malignancy: • Breast cancer (usually sclerotic but 25% mixed) • Lung cancer (usually lytic but 25% mixed) • Testicular cancer • Cervical cancer • Prostate cancer (usually sclerotic but 15% mixed) • Ganglioneuoblastoma • Primary lymphoma of the bone |
Primary bone malignancies: • Chondrosarcoma • Osteosarcoma | Metastases: • Lung cancer | Osteomyelitis |
Metastases: • Prostate cancer • Breast Cancer • Other | Myeloma | Tuberculosis |
Drug exposures: • Vitamin D • Fluoride | Sarcoidosis | Paget’s Disease of Bone |
Fibrous Dysplasia | Aneurysmal bone cyst | Eosinophilic granuloma and Langerhans Cell Histiocytosis |
Paget’s disease of the bone | Chondroblastoma |  |
Osteopoikilosis | Chondromyxoid fibroma | Â |
Osteopetrosis | Hyperparathyroidism (Brown Tumor) | Â |
Pyknodysostosis | Osteomyelitis | Â |
Stress fracture | Intraosseous lipoma | Â |
Hyperparathyroidism | Enchondroma | Â |
| Â | Eosinophilic granuloma | Â |
| Â | Unicameral bone cyst | Â |