[Standardized procedure for suspected bone tumor].

Real bone tumors are rarely encountered in the daily routine of radiological practice. For a general radiologist or surgeon is therefore no need for a specialist knowledge on this field.However, he should be able to distinguish "leave-me-alone-lesions" in order to avoid unnecessary biopsies.A systematic approach towards the interpretation of osteolytic lesions in projection radiograms, e.g. according to the classification of Lodwick, is mandatory. CT and MRI are additional diagnostic tools and are indicated to clear up the true anatomy,e.g. in areas of superposition artefacts in conventional radiology (e.g. axial skeleton) and to determine the inner structure of a lesion, e.g. fatty tissue, liquid/solid. This paper highlights the advantages and disadvantages and the cost-effective use of the imaging modalities including scintigraphy in the diagnosis of bon tumors and tumor-like lesions. Guidelines for the management of bony lesions will be given in detail. The option and necessity for a specialist second opinion is emphasized.