Low-grade intramedullary osteosarcoma presenting with multiple sclerotic bone lesions

Low-grade intramedullary osteosarcoma is a less-aggressive type of osteosarcoma for which delays in diagnosis are common. We present the case of a 42-year-old woman with complaints of low back pain. Multiple imaging evaluations and biopsy procedures were necessary to make the final diagnosis. The key radiologic feature was multiple sclerotic lesions throughout the skeleton, best seen on the bone scan. The difficulties in diagnosing this condition are evident in this case.