To assess the MR imaging features in differentiating a chondroblastoma (CB) from a giant cell tumor (GCT), with an emphasis on the accompanying peritumoral bone marrow edema.

MR imaging findings in 20 patients with CB were compared with the imaging features of 22 patients with GCT. The location of the lesion, signal intensity, adjacent cortical change, degree of accompanying bone marrow edema, synovitis in the adjacent joint and cystic change were analyzed. The findings of CB and GCT were examined statistically with use of Fisher's exact test.

The incidence ratios of MR imaging findings were as follows (CB:GCT). Metaphyseal dominant involvement (2:21), partial cortical disruption (2:14), extensive bone marrow edema surrounding the tumor (14:0) and synovitis in the adjacent joint (11:2) were statistically different in incidence between CB and GCT (p < 0.01). The inhomogeneous signal intensity (17:17) and cystic change (10:15) were not different in incidence between a CB and a GCT.

The presence of metaphyseal dominant involvement and cortical disruption favors a diagnosis of a GCT rather than a CB. In contrast, extensive bone marrow edema surrounding the tumor and synovitis in the adjacent joint are highly indicative of a CB.