Musculoskeletal Radiology Differential Diagnosis

Increased Bone Density

Generalized increased bone density in children
Generalized increased bone density in adults
Solitary sclerotic bone lesions
Multiple sclerotic bone lesions


Regional osteopenia
Generalized osteopenia

Bubbly Bone Lesions

Bubbly bone lesions

Differential Diagnosis Based on Location

Central medullary lesion
Eccentric medullary lesion
Cortical lesion
Parosteal/Juxtacortical lesion
Epiphyseal lesion
Metaphyseal lesion
Diaphyseal lesion

Lucent Bone Lesions

Nonexpansile, lucent medullary bone lesion with sclerosis
Nonexpansile, lucent medullary bone lesion without sclerosis
Ill-defined lucent medullary bone lesion
Well-defined, eccentric expansile, lucent medullary lesion
Grossly expansile lucent bone lesion
Subarticular lucent bone lesion
Lucent bone lesion containing calcium or bone
"Moth-eaten" bone

Other Neoplastic or Neoplastic-like Lesions

Benign tumors with aggressive feathers
"Don't touch lesions"
Non-neoplastic conditions frequrently mistaken for neoplasms
Most common benign and malignant soft tissue tumors

Periosteal Reaction

Some conditions with periostitis of multiple bones
Uninterrupted periosteal reaction
Interrupted periosteal reaction
Irregular or stippled epiphyses

Metapyseal Changes

Solitary radiolucent metaphyseal band
Alternating radiolucent and dense metaphyseal bands
Solitary dense metaphyseal band
Dense vertical metaphyseal lines
Fraying of the metaphyses
Cupping of metaphyses
Erlenmeyer flask deformity
Erosions of the medial metaphysis of the proximal humerus


Erosion or absence of the distal clavicular end
Focal rib lesions (solitary or multiple)


Arthritis with osteopenia
Arthritis with perservation of bone density
Arthritis with periosteal reaction
Arthritis with preserved or widened joint space
Arthritis mutilans

Misc Arthritis

Diffused terminal phalangeal sclerosis
Erosion (enlargement) of the intercondylar notch of the femur
Calcified loose body (single or multiple) in a join
Calcification of articular (hyaline) cartilage (chondrocalcinosis)
Some conditions associated with periarticular calcifications
Bilateral symmetrical sacroilitis
Bilateral asymmetrical sacroilitis
Protrusio Acetabuli
Widening of the symphysis pubis > 7mm
Fusion or bridging of the symphysis pubis
Patterns of Femoral Head Migration
Causes of erosive arthritis of the distal interphalangeal joint


Multiple collapsed vertebrae
Erosion, destruction or absence of a pedicle
Enlarged vertebral body
Squaring of one or more vertebral bodies
Fused vertebrae
Atlanto-axial subluxation
Conditions producing disc space narrowing
Intervertebral disc calcifications
Coronal cleft vertebral bodies
Anterior vertebral body beaking
Posterior scalloping of the vertebral bodies
Anterior scalloping of the sacrum
Ivory vertebrae




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