Bone-RADS™ v. 2023

ACR's Bone Reporting and Data System (Bone RADS)

Is there a pathological fracture?
Is there evidence of extra-osseous soft tissue mass?
Does the patient have a known primary cancer?
How is the lesion’s margination / zone of transition?
Is there periosteal reaction?
Is there endosteal scalloping?

Bone-RADS Score: 0

Incompletely characterized
Further evaluation is necessary.

Bone-RADS Score: 1

Very low risk of malignancy (very likely benign)
Extended interval surveillance of asymptomatic benign bone lesion or Orthopedic oncology referral for treatment of symptomatic benign bone lesion

Bone-RADS Score: 2

Low risk of malignancy (probably benign)
Orthopedic oncology referral for further tumor characterization, surveillance planning, or treatment planning

Bone-RADS Score: 3

Intermediate risk of malignancy (potentially malignant)
Orthopedic oncology referral for possible biopsy and treatment planning

Bone-RADS Score: 4

High risk of malignancy (highly suspicious for malignancy)
Orthopedic oncology referral for treatment planning of presumed malignancy


  1. Marek says:

    It seems that this calculator incorrectly assigns 4 points for a soft tissue mass, while according to the ACR’s page for Bone-RADS it should assign 2 points only. May you please verify this and fix the bug? Thank you.

  2. Marek says:

    Thank you for your reply! Now I realized that the cause of the confusion is on the ACR’s page for Bone-RADS, because the presence of a soft tissue mass is differently assessed in two documents:
    – 2 points in the “Bone-RADS TM v2023 Assessment Categories and Scoring System”
    – 4 points in the “Bone-RADS TM – Radiography Imaging Report Template for Potentially Neoplastic Bone Lesions”.
    Is there a way to check which document contains an error?

Leave a Reply

Your email address will not be published. Required fields are marked *