What to Know About Sclerotic Lesions

Medically Reviewed by Murtaza Cassoobhoy, MD on May 28, 2023
Written by WebMD Editorial Contributor
4 min read

The word lesion refers to an abnormal change in the structure of your bones. Sclerotic means that the lesions are slow-growing changes to your bone that happen very gradually over time. Most of the time, sclerotic lesions are benign. 

Sclerotic lesions can be malignant or benign. They are usually localized to a single bone or area of your body. A malignant lesion is often cancerous, posing a risk to your health if it is not treated early. Malignant growths form on your bone, growing rapidly and spreading to other bones in your body and even your organs.

In some cases, cancer doesn’t originate in your bones. Cancer from other areas of your body can metastasize, spreading into your bone and causing lesions as a secondary complication. These lesions are known as metastatic lesions.

Doctors have not pinpointed an exact cause of benign bone lesions. However, they suspect it has to do with something that happens during the process of growing. Most bone lesions are diagnosed in younger patients.

In rare cases, sclerotic lesions don’t cause any symptoms and are diagnosed later in adulthood. Still, it is likely that the lesions began forming during childhood.

There are many variables and causes to consider when determining the severity of sclerotic lesions, including:

  • Sinus tracts along a sclerotic area of your bone may indicate the presence of osteomyelitis, also known as an infection of the bone.
  • Sickle cell disease often leads to a loss of blood flow to an area of bone, which in turn causes sclerotic lesions. 
  • Evidence of collapse in the subchondral bone plate where two bones connect is a sign of osteonecrosis, which is your bone dying. 
  • If you have a history of malignant diseases like cancer, sclerotic lesions due to metastasis are more likely. 
  • Some drugs and minerals contribute to sclerotic bone lesions, so talk to your doctor before adding a new medication or supplement to your diet. 
  • If you suspect trauma caused a sclerotic lesion, your doctor will review stress fractures in the area to see if the damage aligns. 
  • Health conditions like hyperparathyroidism and Paget’s disease contribute to sclerotic bone lesions.

A benign bone growth doesn’t usually pose a risk to your health aside from the possibility of pain and discomfort. In some cases, sclerotic bone lesions may cause visible deformities or impact organ function. Signs of sclerotic bone growth include:

  • Fever
  • Night sweats
  • Soreness at the site of the lesion
  • Pain when your bump or injure the area of the lesion

While early sclerotic lesions do not require treatment, eventually your bone growth may need to be addressed. The good news is that treatment is usually simple and straightforward. 

Medical treatment. Your doctor will assess the type of lesion you have as well as its size, age, and location. If possible, your doctor may want to avoid doing surgery. Instead, they may monitor the sclerotic lesion to see how it grows and changes over time. If you’re in pain, your doctor can recommend an over-the-counter pain medicine to help with any discomfort.

If your bone growth appears to be accelerating, your doctor may ask for additional tests to see if the growth is cancerous. While most slow-moving growths are benign, there is always a possibility that cancer has entered the cells.

Surgical treatment. Malignant growths are primarily treated by removing them during surgery. After the growth is gone, your doctor may recommend radiation and chemotherapy to kill any remaining malignant cells. This will help to prevent the growth from returning in the future.

Eventually, your sclerotic lesion may require surgical removal, even if it’s benign. Surgery is a great option because it removes the growth while still preserving healthy bone regeneration at the site of the lesion. Your doctor biopsies a sample of the bone tissue and views it under a microscope to determine if it is malignant.

This type of surgery requires specific knowledge and training, so your doctor may refer you to a specialist for the procedure. After surgery, the chances of benign growth returning are less than 5%.

With any surgery, there is a risk that something could go wrong. However, addressing a sclerotic lesion is straightforward. During surgery, the bone growth is cut or scraped off and the healthy bone is grafted to promote healing.

Risks with surgery include nerve injury, infection, bleeding, and stiffness. Make sure you clean and care for the surgery site to prevent any additional issues.