X-ray
Lateral
Frontal
Frontal
Lateral
Frontal
Diffuse mixed lytic-sclerotic lesions with areas of a permeative process involving the proximal epiphysis and meta-diaphysis of the right tibia with a wide zone of transition associated with cortical thickening. No periosteal reaction or cortical breakthrough. Minimal soft tissue thickening anterior to the mid tibia bone.
The differential diagnosis of such an appearance is wide and may include Ewing sarcoma, osteosarcoma, leukaemia or lymphoma, metastasis, or chronic osteomyelitis.