Primary Bone Tumors (single site of disease) may present with local and systemic symptoms.
Local symptoms:
- Pain
- Increasingly severe
- Interferes with sleep
- Localized to involved site
- Adjacent soft tissue swelling
Systemic symptoms:
- Fever
- Night sweats
- Weight loss
Pain is often a predominant feature.
Significant back pain in a child is unusual and should raise concerns about possible malignancy.
Differential Diagnosis of a Primary Bone Tumor:
Congenital vs Acquired |
|
|
Inflammatory |
Infection | Osteomyelitis |
| Tuberculosis | ||
| Non-infectious | Arthritis and Tendonitis | |
| Traumatic | Injury | |
Neoplastic |
Benign | Aneurysmal Bone Cyst
|
| Giant cell Tumor | ||
| Langerhans Cell Histiocytosis (can have a aggressive course) | ||
| Malignant | Ewing Sarcoma | |
| Osteogenic sarcoma | ||
| Primary Lymphoma of bone | ||
| Metastatic disease from another site (eg. rhabdomyosarcoma) |
Multiple Bone Lesions
Differential Diagnosis of Multiple bone lesions:
Inflammatory |
Infection | Disseminated Osteomyelitis |
| TB | ||
| Non-infectious | Rheumatoid arthritis | |
| Traumatic | Injury | Multiple metastatic bone deposits in neuroblastoma can sometimes be misdiagnosed as non-accidental injury |
Neoplastic |
Malignant | Primary bone marrow malignancy - leukemia ALL, AML, CML
|
Metastatic disease to bones. For example:
|
