Abstract
The study aims at looking into clinical, radiological and histopathological agreement in diagnosing bone tumors and elaborates the spectrum of bone tumors referred to Black-Lion Hospital, BLH. All bone tumor patients, who presented to all the three departments at BLH between the study periods of December 2003 – March 2008 were recruited. the radiological and histopathological diagnoses made were categorized separately using WHO classification of bone tumors. Strength of agreement was measured using Cohen’s Kappa test. From the total of 216 bone tumor patients presented and biopsied in the five year period, complete information could not be gathered only for 11 (5%) of the patients. Hence there were 111(51.3%) males and 94(48.7%) females with histopathological tissue diagnosis of the bone tumor. Male to female ratio was nearly 1. Commonest age range generally affected was 15-29 (7-55 years). Of the tumors histopathologically diagnosed, 36%( 74/205) of the tumors were malignant. The commonest primary malignant tumor from bone biopsy was osteosarcoma (52/182, 28.5%). It was also the single most common clinical, radiological and histological diagnosis made. Exostosis was second. Considering all bone tumors together, radiological diagnosis was confirmed by similar histological diagnosis in 172 out 205 cases (84%) and the corresponding Cohen's kappa value (0.82) showed excellent agreement between radiological and histological diagnoses of all bone tumors. In set-ups where there is limited or no histopathological service, joint clinical and radiological decision could lead to a higher degree of accuracy in diagnosis of bone tumors. Key words: Bone tumors, diagnostic agreement, radiological, orthopedic, histopathology.