For educational and reference use only. These calculators do not replace clinical judgement, local protocols, or a qualified clinician. Verify every result independently before it informs patient care.

Musculoskeletal imaging

Bone-RADS (Incidental Bone Lesion, CT)

Society of Skeletal Radiology Bone-RADS for a SOLITARY, incidentally detected bone lesion on CT. Answer the features to derive the management category. The most aggressive feature governs.

Concerning Features (Select All Present)

Definitely Benign Feature Present?

Known Primary With Bone-Metastatic Propensity?

Kidney, prostate, breast, lung or thyroid.

Result

Bone-RADS 2–3

Indeterminate: additional imaging (MRI / PET / bone scan), or follow-up CT at 6, 6 and 12 months.

BR2–3: further imaging / follow-up

Formula

In the SSR order: any concerning feature → BR4; else a known bone-seeking primary → BR2–3; else cartilage matrix outside a long bone → BR2–3; else a definitely-benign feature → BR1; else indeterminate → BR2–3. BR1 leave alone · BR2 different modality · BR3 follow-up (6, 6, 12 mo) · BR4 biopsy/referral.

References

Chang CY, Garner HW, Ahlawat S, et al. Society of Skeletal Radiology white paper: guidelines for the diagnostic management of incidental solitary bone lesions on CT and MRI in adults (Bone-RADS). Skeletal Radiol 2022;51(9):1743–1764.

Disclaimer

Implements the CT terminal logic for a SOLITARY lesion. The full SSR flowcharts separate lucent from sclerotic/mixed lesions with additional entity-specific criteria and HU thresholds. Follow the complete algorithm. Not for multiple lesions.

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