The most common classification of bone tumors is by dignity, that is, whether they are benign (benign) or malignant (malignant):
| Benign tumors | Tissue of origin |
| Benign fibrous histiocytoma | Connective tissue |
| Chondroblastoma (Codman tumor) | Cartilage tissue |
| Desmoplastic bone fibroma | Connective tissue |
| Enchondroma | Cartilage tissue |
| Fibrous bone dysplasia (Jaffe-Lichtenstein) | Connective tissue |
| Bone hemangioma | Vessels |
| Nonossifying fibroma (NOF) | Connective tissue |
| Ossifying bone fibroma (synonym: osteofibroma) (semimalignant). | Connective tissue |
| Osteoblastoma (synonym: giant osteoid osteoma). | Bone tissue |
| Osteochondroma (synonym: cartilaginous exostosis; ecchondroma). | Cartilaginous tissue |
| Osteoid osteoma | Bone tissue |
| Osteoma | Bone tissue |
| Giant cell tumor (osteoclastoma) | Connective tissue |
| Malignant tumors | |
| Chondrosarcoma (primary, secondary) | Cartilage tissue |
| Ewing’s sarcoma | Bone marrow |
| Malignant fibrous histiocytoma (MFH). | Connective tissue |
| Osseous fibrosarcoma | Connective tissue |
| Osteosarcoma | Bone tissue |
| Plasmocytoma (synonyms: medullary plasmocytoma; multiple myeoloma, Kahler’s disease). | Bone marrow |
Lodwick classification
By means of the Lodwick classification, it is possible to assess whether the tumor is benign (benign) or malignant (malignant) on an X-ray. Furthermore, it is suitable for the assessment of progression in the case of aggressive behavior of the tumor.
An index for the growth rate of the bone tumor or an inflammatory process is the reaction visible on the X-ray, i.e. the bone structure is modified locally, regionally or diffusely by the tumor. The visible patterns of destruction are classified into the following main groups:
| Grade | Growth rate | Bone destruction | Dignity | Bone tumors |
| Grade I | Purely geographic (circumscribed); boundary definable | |||
|
Very slow growing | Sclerosis (pathological hardening of here: tissues) and sharp boundary | benign | Chondroblastoma, enchondroma, fibrous bone dysplasia, nonossifying fibroma, osteoid osteoma |
|
Slow growing (displacing) | Bone distention > 1 cm and/or no sclerosis | actively benign | Giant cell tumor |
|
Mean growth rate(locally invasive) | Total compact penetration (compacta = outer marginal layer of bone). | aggressive benign | Chondro-, osteo-, fibrosarcomas |
| Grade II | fast growing | Geographic, with moth-eaten/permeated (without respect for anatomical boundaries) component | predominantly malignant | Chondrosarcoma, fibrosarcoma, malignant fibrous histiocytoma, metastases, osteosarcoma |
| Grade III | very fast growing | purely moth-eaten or permeative destruction | malignant | Ewing’s sarcoma |
The classification is particularly suitable for tumors of a long bone or small bone. However, it is neither sensitive nor specific, so that further diagnostic measures are usually indispensable.
