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Table 3 Differential diagnosis of sclerotic and lytic bone lesions

From: Retinal vasculitis with Chronic Recurrent Multifocal Osteomyelitis: a case report and review of the literature

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  
Osteopetrosis Hyperparathyroidism (Brown Tumor)  
Pyknodysostosis Osteomyelitis  
Stress fracture Intraosseous lipoma  
Hyperparathyroidism Enchondroma  
  Eosinophilic granuloma  
  Unicameral bone cyst