Musculoskeletal
Monitoring
It is recommended that survivors of childhood cancer have yearly re-evaluations with their HCP for chronic health problems.
Screening for late musculoskeletal problems should include a history to ascertain if there are any symptoms of:
- Joint and bone pain with limited mobility
Patients with osteoporosis are very likely to be asymptomatic - unless they have had a fracture.
Physical examination should assess:
- Joint function and deformity
- Spinal deformity and scoliosis
An orthopedic consultation is recommended for any child with a skeletal growth deficit leading to asymmetry (limb length discrepancy) or scoliosis.
Scoliosis
Spinal scoliosis should be monitored carefully to check that this problem is not progressive.
Osteoporosis
Osteoporosis is a significant risk. Bone density should be checked at entry into a long term follow up program and then intermittently using DEXA - but there are no clear guidelines as to how often this study should be performed.
