Cystic bone lesions

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Lesion by Location[1]

Differential Diagnosis

Fog Machines or Fegnomashic

Lesions in Patients Younger Than 30 Years Old

Epiphyseal Lytic Lesion in Patients Younger Than 30 Years Old

Cystic Rib Lesion - FAME

Epiphyseal Lesion - CAGGIE

  • Chondroblastoma (<25 yo, Ca++ <50%), Clear Cell Chondrosarcoma (>25 yo, rare, +/- Ca++), Chondromyxoid fibroma (metaphyseal, rare, Ca++ rare)
  • Arthritis, Aneurysmal bone cyst (from metaphysis, expansile)
  • Giant cell tumor (from metaphysis, no matrix, no sclerotic borders, 25-50 yo)
  • Ganglion cyst (young adults, no DJD, no matrix)
  • Infection (younger patients)
  • Eosinophilic granuloma (young, rare in epiphysis)

Also consider these locations as Epiphyseal Equivalents: lesser tuberosity, patella, most apophyses

Four Horsemen of the Apophysis - Chondroblastoma, ABC, GCT, Infection

Fluid Fluid Levels in Lytic Lesion - GOAT


  1. Madewell JE, Ragsdale BD, Sweet DE. Radiologic and pathologic analysis of solitary bone lesions. Part I: Internal margins. Radiol Clin N Am 1981;19:715-748.