Radiolucent bone lesions are encountered commonly by orthopedic surgeons and other clinicians in everyday practice. Often difficulties arise with the proper evaluation and management of these findings. A systematic approach, however, based on careful analysis of information gained from the history and physical examination combined with the important factors of patient age and plain radiographic features, will guide the clinician in formulating a reasonable differential diagnosis and management plan. A specific histologic diagnosis of every radiolucent lesion is not needed. Whereas active and malignant lesions require treatment, many lesions are inactive or discovered incidentally and may only need observation. Algorithms are provided to simplify the evaluation of these lesions.
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