Diagnosis

X Ray will be the initial modality to detect both fractures and bone lesions.

Features more suggestive of benign bone lesions:

• Well-defined with sclerotic borders
• No break in the cortex
• No soft tissue involvement
• Solitary
• Possibly cystic morphology
• No deformity or destruction of bone

Features concerning for malignant bone lesions:

• Heterogeneous appearance
• Periosteal reactions
• Multiple lesions
• Poorly defined margins
• Bony destruction

CT or MRI may be indicated later for workup of the lesion or fracture but are rarely indicated in the ED.