Obligatory medical device diagnostics.
- Conventional radiograph of affected body region, in two planes – to assess extent of tumor growth; NOF appears cystic, marginal; often clustered grape-shaped brightenings with dense, garland-shaped marginal sclerosis; lesion may cross bone borders
- If necessary, computed tomography (CT; sectional imaging procedure (X-ray images from different directions with computer-based evaluation)) – provides only little additional information to the X-ray image
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 (NOF), 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 (MFH), 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.
