Obligatory medical device diagnostics.
- Conventional radiograph of the affected body region, in two planes – to assess the extent of tumor growth; characteristically, one:
- Epiphyseal/metaphyseal eccentric location of osteolytic areas (areas of bone dissolution), which may extend below the articular cartilage
- Chambered looking structure, usually no sclerosis, smooth marginal border.
- 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?).
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.