Bone Reporting and Data System
Bone-RADS is an ACR work-in-progress framework for the incidentally detected bone lesion — the sclerotic or lytic focus found on a scan ordered for something else, where the real question is “leave it, follow it, or work it up.” It proposes a structured pathway from imaging features to a management recommendation, aiming to standardize an area that today swings between over-investigation and missed aggressive lesions. As a work-in-progress it is not yet endorsed for routine practice, but it slots naturally alongside Fleischner as the musculoskeletal counterpart to “incidental-finding” guidance.
A proposed structured pathway from imaging features to a management recommendation for the incidentally detected bone lesion. Approved by the ACR RADS steering committee for development; not yet endorsed for routine use.
Bone-RADS 1 on MRI had 100% NPV for vertebral lesions (95% CI 94.7-100%, n=46). Bone-RADS 2/3 lesions had 3.4% malignancy rate, falling to 0% with clinical criteria. Inter-reader agreement was moderate (κ=0.60).
RadPigeon is an independent radiology news digest and is not affiliated with or endorsed by ACR (Works-in-Progress). “Bone-RADS” is a trademark of its owner and is named here only to refer to the system. Always consult the official source for the exact, current criteria.