Surgical treatment of bone tumours in the extremities nowadays only rarely requires amputation even in the case of malignant tumours. The aim is to use limb sparing surgery using large artificial joints or banked bone to replace the removed bone. The diagnosis of a primary bone tumour is based on clinical suspicion and x-ray findings. The abnormalities may sometimes be difficult to detect from routine x-rays. Magnetic resonance imaging or computed tomography scanning are used as second-line investigations. If a suspicion of malignancy remains, a biopsy specimen through the smallest possible incision is obtained, nowadays preferably under CT guidance. The procedure is performed at the unit that will carry out any subsequent treatment (university hospital). Bone scintigraphy and laboratory tests should be used as supplementary investigations.