[Standards and diagnostic strategies in diagnosis of bone tumors and tumor-simulating lesions].

Real bone tumors are rarely encountered in the daily routine of radiological practice. Therefore, for a general radiologist there is no need for a specialist knowledge on this field. However, he should be able to distinguish benign from malignant lesions in order to avoid unnecessary biopsies. A systematic approach towards osteolytic lesions, e.g. according to the classification of Lodwick, is mandatory. CT and MRI are indicated to clear up the anatomy in areas of superposition artefacts in conventional radiology 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 bone 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.