Mandatory medical device diagnostics.
- Conventional radiography of the affected body region, in two planes – to assess the extent of tumor growth; characteristically, one:
- Epiphyseal/epimetaphyseal eccentric location of the osteolytic area (sharply defined area of bone dissolution) with round to oval shape.
- Geographic osteolysis is often surrounded by a sclerotic space
- The cortical bone (outer layer of bone) is rarely breached
- Often there is a distension of the bone
- Magnetic resonance imaging (MRI; computer-assisted cross-sectional imaging (using magnetic fields, that is, without X-rays)) – for the purpose of determining the location, size, and extent of the tumor (soft tissue infiltration? intramedullary spread in the bone marrow? Involvement of the spinal canal?)
Regular check-ups (follow-up).
- X-ray of the thorax (X-ray thorax/chest), in two planes – in case of local recurrence (recurrence of the disease).
- Pulmonary metastasis (lung metastases) is rare but possible
- Long-term clinical controls, as metastasis is still possible after 30 years (mean 8.3 years)
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 further diagnostic measures are usually indispensable.
