On plain X-ray and CT radiological appearance could represent aggressive bony lesion or osteomyelitis. However, clinical presentation of pain following minimal trauma and no infective symptoms made osteomyelitis unlikely.

On MRI osteomyelitis is excluded as there is no extension of edema past the areas of enhancing lesion.

The laminated appearance of the periosteal reaction is usually more commonly seen in Ewing's sarcoma with a sunburst appearance more commonly seen in Osteosarcoma. However, both patterns can be seen in osteosarcoma, Ewing's Sarcoma and osteoblastic metastases.