Last reviewed: August 2019
Last updated: February  2019

Summary

Definition

History and exam

Key diagnostic factors

  • childhood and adolescence
  • worsening pain over weeks to months
  • mass/swelling

Other diagnostic factors

  • male sex
  • limp
  • history of trauma
  • limited range of motion
  • overlying skin ulceration

Risk factors

  • childhood and adolescence
  • Paget disease
  • radiation therapy
  • Rothmund-Thomson syndrome
  • familial retinoblastoma syndrome
  • Li-Fraumeni syndrome
  • fibrous dysplasia
  • chemotherapy
  • male sex

Diagnostic investigations

1st investigations to order

  • conventional radiographs
  • serum alkaline phosphatase
  • serum lactate dehydrogenase
Full details

Investigations to consider

  • CT primary tumor
  • MRI primary tumor
  • CT thorax
  • radionuclide bone scan
  • 18F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG-PET-CT)
  • bone biopsy
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Chief

Division of Pediatric Hematology, Oncology, and Marrow & Blood Cell Transplantation

Children's Hospital at Montefiore

Associate Professor, Pediatrics

Associate Professor, Developmental and Molecular Biology

Albert Einstein College of Medicine

Bronx

NY

Disclosures

DL declares that he has no competing interests.

Dr David Loeb would like to gratefully acknowledge Dr Luminita Rezeanu and Dr Michael J. Klein, the previous contributors to this topic. LR and MJK declare that they have no competing interests.

Peer reviewers VIEW ALL

Professor of Surgery

Ellis Fischel Cancer Center

University of Missouri

Columbia

MO

Disclosures

ES declares that he has no competing interests.

Locum Consultant Paediatric Oncologist

University College Hospital

London

UK

Disclosures

RW declares that she has no competing interests.

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