Please confirm topic selection

Are you sure you want to trigger topic in your Anconeus AI algorithm?

Please confirm action

You are done for today with this topic.

Would you like to start learning session with this topic items scheduled for future?

Updated: Dec 27 2021


  • Snapshot
    • An 13-year-old boy presents to his pediatrician for right distal thigh pain. He has been having pain in this area for the past few months, has progressively worsened, and persists in the night. Physical examination is notable for tenderness upon palpation above the right knee. A radiograph of the distal thigh demonstrates a sunburst pattern and Codman triangle.
  • Introduction
    • Overview
      • malignant bone tumor secondary to overproduction of osteoid cells by malignant cells
        • most commonly affecting the metaphysis of bone
  • Epidemiology
    • Incidence
      • bimodal age distribution
        • adolescence and adults > 65 years of age
    • Risk factors
      • Paget disease of the bone
      • prior irradiation or chemotherapy
      • familial retinoblastoma
      • Li-Fraumeni syndrome
      • teriparatide use
    • Pathophysiology
      • unclear
    • Associated conditions
      • Paget disease of the bone
      • familial retinoblastoma
      • Li-Fraumeni syndrome
  • Symptoms
    • Symptoms
      • localized pain
        • typically over several months
        • location
          • metaphyseal regions
            • distal femur
            • proximal tibia
            • proximal humerus
      • systemic symptoms are generally absent
        • e.g., weight loss, fever, and nightsweats
    • Physical exam
      • may have a mass at the site of involvement
  • Imaging
    • Radiography
      • indication
        • initial imaging study
      • finding
        • Codman triangle
          • periosteal new bone formation
        • radiodense and radiolucent areas with bone cortex destruction
          • mostly in the metaphyseal region of bone
        • sunburst appearance
          • new bone formation perpendicular to the shaft of the bone
    • MRI
      • indication
        • to determine the extent of disease
          • important to do the involved entire long bone to find any skip lesions
    • Radionuclide bone scan
      • indication
        • to evaluate for metastatic disease
  • Studies
    • Invasive studies
      • open or core biopsy
        • indication
          • used to confirm the diagnosis
    • Histology
      • findings
        • pleomorphic osteoid-producing cells
  • Differential

    • Ewing sarcoma
      • differentiating factors
        • anaplastic small, round, and blue cells with scant cytoplasm
        • typically affects the diaphysis
  • Treatment
    • Treatment consists of surgical resection (even amputation), chemotherapy, and radiation therapy
      • depends on the grade and extent of the disease
  • Complications
    • Metastasis
    • Amputation
  • Prognosis
    • Prognostic variable
      • positive
        • low-grade
        • negative resection margin
      • negative
        • metastasis
        • unresectable or partially resectable
        • large tumor size
1 of 0
1 of 1
Private Note

Attach Treatment Poll
Treatment poll is required to gain more useful feedback from members.
Please enter Question Text
Please enter at least 2 unique options
Please enter at least 2 unique options
Please enter at least 2 unique options